Dysfunctional Uterine Bleeding and its Management Strategy

Ganesh Dangal
In: Journal of Nepal Medical Association · 2003 · vol. 40(138) , pp. 98–106 · doi:10.31729/jnma.848 · W2483589860
article OA: diamond CC0
🔓 Open OA copy View on OpenAlex View at publisher

Abstract

Dysfunctional uterine bleeding (DUB) is a diagnosis of exclusion. An adequateexamination of the abdomen and the pelvis and uterine curettage, hysteroscopy or atleast an endometrial biopsy is essential to exclude organic disease of the uterus. Itoccurs most frequently at the extremes of menstrual life, but it can develop at anyintervening time.The objectives of treatment are to control the acute bleeding, avert future episodes,and prevent a serious long-term consequence of anovulation, endometrial cancer. Themainstay of treatment has been medical therapy although surgical intervention isrequired in some cases. If the bleeding is severe and / or recurrent or the medicaltreatment fails, re-evaluation is needed.Adolescent DUB is due to immaturity of the hypothalamus and pituitary and menstrualcycles may be anovulatory. In teenage girls organic disease is rare and DUB usuallygets resolved spontaneously. That's why they are treated expectantly and curettage isoften delayed.In the middle years of reproductive life (20-39yrs), benign organic disease is common,and curettage is usually performed to exclude complications of pregnancy and otherdisease. Conservative therapy is usually indicated, though hysterectomy may beindicated if bleeding is severe or recurrent and patient has completed her family.Perimenopausal DUB is due to the decreased number of ovarian follicles and theirincreased resistance to gonadotrophin stimulation, there is a possibility of malignancy.So, these women should always be investigated by curettage or hysteroscopy withoutdelay. Although conservative therapy may be tried as a temporizing measure,hysterectomy is often indicated.Key Words: Dysfunctional uterine bleeding, curettage, hysteroscopy, and progestogen.

My notes (saved in your browser only)

Citation neighborhood (sparse)

Too few in-corpus citations on either side for a chart; here are the lists.

Cites (4)

References (16)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK