{"paper_id":"092a8440-e4d5-4950-9cb8-d60d868c1cb2","body_text":"Dysfunctional Uterine Bleeding and its Management Strategy\nDOI:\nhttps://doi.org/10.31729/jnma.848Abstract\nDysfunctional uterine bleeding (DUB) is a diagnosis of exclusion. An adequate\nexamination of the abdomen and the pelvis and uterine curettage, hysteroscopy or at\nleast an endometrial biopsy is essential to exclude organic disease of the uterus. It\noccurs most frequently at the extremes of menstrual life, but it can develop at any\nintervening time.\nThe objectives of treatment are to control the acute bleeding, avert future episodes,\nand prevent a serious long-term consequence of anovulation, endometrial cancer. The\nmainstay of treatment has been medical therapy although surgical intervention is\nrequired in some cases. If the bleeding is severe and / or recurrent or the medical\ntreatment fails, re-evaluation is needed.\nAdolescent DUB is due to immaturity of the hypothalamus and pituitary and menstrual\ncycles may be anovulatory. In teenage girls organic disease is rare and DUB usually\ngets resolved spontaneously. That's why they are treated expectantly and curettage is\noften delayed.\nIn the middle years of reproductive life (20-39yrs), benign organic disease is common,\nand curettage is usually performed to exclude complications of pregnancy and other\ndisease. Conservative therapy is usually indicated, though hysterectomy may be\nindicated if bleeding is severe or recurrent and patient has completed her family.\nPerimenopausal DUB is due to the decreased number of ovarian follicles and their\nincreased resistance to gonadotrophin stimulation, there is a possibility of malignancy.\nSo, these women should always be investigated by curettage or hysteroscopy without\ndelay. Although conservative therapy may be tried as a temporizing measure,\nhysterectomy is often indicated.\nKey Words: Dysfunctional uterine bleeding, curettage, hysteroscopy, and progestogen.\nDownloads\nPublished\nHow to Cite\nIssue\nSection\nLicense\nJNMA allow to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. The author(s) are allowed to retain publishing rights without restrictions. The JNMA work is licensed under a Creative Commons Attribution 4.0 International License. More about Copyright Policy.","source_license":"CC0","license_restricted":false}