UTERINE BLEEDING, DYSFUNCTIONAL

General Information

DEFINITION--Bleeding that is not related to a woman's normal menstrual pattern and is not associated with tumor, inflammation or pregnancy.

BODY PARTS INVOLVED--Uterus; vagina.

SEX OR AGE MOST AFFECTED--Female adolescents and premenopausal adults.

SIGNS & SYMPTOMS--Bleeding between menstrual cycles. Blood flow may be irregular, prolonged and sometimes profuse.

CAUSES--Usually caused by an overgrowth of the endometrium (lining of the uterus) due to estrogen stimulation.

RISK INCREASES WITH

• Polycystic ovary syndrome.
• Obesity.
• Use of synthetic estrogen without added progestin.

HOW TO PREVENT

• Maintain proper weight.
• Follow medical advice regarding any hormone therapy.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Endometrial aspiration (insertion of a thin tube into the uterus to obtain a sample of the lining) to determine if bleeding is associated with ovulation. This will help determine how to evaluate the cause. Numerous diagnostic tests may have been done previously to rule out other causes of bleeding. Dysfunctional uterine bleeding is the usual diagnosis for patients without discernible causes and is usually not ovulatory.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Treatment is usually with hormonal therapy and lifestyle changes if appropriate.
• If hormonal therapy does not control the bleeding, a dilatation and curettage, often referred to as D & C (dilatation of the cervix and a scraping out of the uterus with a curette), may be performed to check for other problems.

POSSIBLE COMPLICATIONS--Anemia.

PROBABLE OUTCOME--Usually curable in 2 or 3 months, sooner with surgery. Recurrence is common, depending on the underlying cause.

How To Treat

GENERAL MEASURES--

• Use heat to relieve pain: Place a heating pad or hot-water bottle on the abdomen or back. Take a hot bath for 10 to 15 minutes as often as needed.
• Stressful situations and emotional turmoil or excessive use of drugs or alcohol can contribute to the problem. Try to resolve any conflicts in your life and get help in discontinuing abusive behaviors.
• Avoid aspirin, especially if you are anemic.

MEDICATION--Your doctor may prescribe:

• Hormones to correct a hormone imbalance.
• Pain relievers if needed.
• Tranquilizers to reduce anxiety (rarely required).

ACTIVITY--Stay as active as possible, depending on the underlying condition. Consult your doctor about continuing sexual relations.

DIET--No special diet. Iron supplements may be necessary for anemia.

Call Your Doctor If

• You have abnormal uterine bleeding.
• The following occurs during treatment: Bleeding becomes excessive. (You saturate a pad or tampon more often than once an hour.) You develop signs of infection, such as: fever; a general ill feeling; headache; dizziness; or muscle aches.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.