1. DYSFUNCTIONAL UTERINE BLEEDING

3. DEFINITION
DUB is defined as a state of abnormal uterine bleeding without any clinically detectable organic, systemic and iatrogenic causes
Tumour, inflammation or pregnancy is excluded

4. INCIDENCE
10%

5. TYPES
OVULAR BLEEDING
ANOVULAR BLEEDING

6. CAUSES OF OVULAR BLEEDING
Polymenorrhoea or Polymenorrhagia
Causes
Hyper stimulation of follicular growth by FSH
Follicular growth is speeded up
Shortening of follicular phase
Occurs following child birth,abortion,adolescence,premenopausal period and PID

7. CAUSES OF OVULAR BLEEDING
Oligomenorrhoea
Causes
Ovarian unresponsiveness to FSH
Secondary to pituitary dysfunction
Undue prolongation of the proliferative phase with normal secretory phase

8. CAUSES OF ANOVULAR BLEEDING
Menorrhagia
Decreased progesterone due to anovulation
Endometrial growth is under estrogen
Cystic glandular hyperplasia
Type of abnormal bleeding
Met in premenopausal women
Due to disturbance in ovarian function or release of gonadotrophins

9. MANAGEMENT EVALUATION OF ABNORMAL UTERINE BLEEDING
PROGESTERONE ESTROGEN COMBINATION
DIALATATION AND CURETTAGE
HYSTRECTOMY
LASER ABLATION
TREAT ANAEMIA