Spectrum of dysfunctional uterine bleeding and its conservative management

OBJECTIVE: To find out the proportion of dysfunctional uterine bleeding (DUB) and the response of patients of DUB to medical treatment at Abbasi Shaheed Hospital. DESIGN: Cross sectional and comparative study. PLACE AND DURATION OF STUDY: The study was conducted in Gynaecology Unit II of Abbasi Shaheed Hospital, Karachi, from December 1999 to December 2000. PATIENTS AND METHODS: The study included 210 Gynae patients between the age group 13-50 years presenting with DUB. These patients were divided into adolescent, reproductive and perimenopausal group. They were initially assessed by general and pelvic examination, ultrasound of pelvis, Pap smear, hysteroscopy and diagnostic curettage. Results were recorded. The efficacy of treatment was assessed in terms of reduction in the amount of blood loss. RESULTS: Two hundred and ten out of 1300 patients were diagnosed as having DUB with the proportion of 16.1%. Response rate was 20 30 % with oral mafenamic acid, 50% with capsule tranexamic acid, 60% and 50% respectively with oral contraceptive pills containing ethinylestradiol and norethisterone, and norethisterone alone. The response rate with capsulated micronised flavonoid and derivative of ethinyltestosterone was 90% and 75% respectively. CONCLUSION: The patients in adolescent age group are good responders to conservative treatment. Most of the patients preferred micronised flavonoid over derivative of ethinyltestosterone for some misconceptions regarding this medicine. The former was better tolerated with less side effects.