Demystifying Dysfunctional Uterine Bleeding (DUB): Causes, Concerns, and Treatments

Understanding Dysfunctional Uterine Bleeding (DUB)

Dysfunctional uterine bleeding (DUB) is characterized by abnormal uterine bleeding unrelated to pregnancy or identifiable uterine, pelvic, or systemic diseases. It stems from a functional issue in the uterus, primarily hormonal imbalance, rather than a structural problem. Typically manifesting as heavy menstrual bleeding (menorrhagia), a diagnosis of DUB is only made after ruling out other potential causes for abnormal bleeding.

Who is at Risk and Why It Matters

DUB is a common concern affecting almost every woman at some point in her life. It is prevalent in adolescents and women nearing menopausal age. Studies indicate that nearly 80% of cases involving heavy menstruation (more than 80 mls per month) are attributed to DUB. Besides posing medical risks such as iron deficiency anemia, DUB can have social implications, causing discomfort and even affecting work and school attendance.

Other Causes of Abnormal Menstrual Bleeding

Apart from DUB, various structural and systemic issues must be explored before arriving at a diagnosis. Other potential causes include:

  • Uterine Fibroids
  • Uterine Polyps
  • Uterine Hyperplasia
  • Uterine Cancer
  • Adenomyosis
  • Intrauterine Device (IUCD)
  • Thyroid Disease
  • Blood Disorders
  • Kidney Disease

Treatment Approaches for DUB: Insights from Your Gynecologist

Addressing abnormal menstrual bleeding, while often related to hormonal imbalances, necessitates a comprehensive examination to exclude other potential causes. Your gynecologist will gather information about your health history and menstrual cycle, and may order tests like a pap test and pelvic ultrasound. For women over 40, an endometrial biopsy and hysteroscopy may be recommended to rule out serious conditions like endometrial hyperplasia or cancer.

Medical Treatment Options for DUB

Several medical treatments are available, tailored to age and reproductive preferences:

  • Tranexamic Acid: Reduces menstrual blood loss by 50% when taken for 5 days during heavy periods. Recommended as a first-line therapy for young women and adolescents.
  • NSAID/Ponstan: Effective in reducing menstrual blood loss by 30-50% and providing relief from period cramps when taken for a few days during heavy periods.
  • OCPill (Oral Contraceptive Pill): Daily consumption for months reduces menstrual blood loss by 30-50%, alleviating period cramps, and offering pregnancy protection.
  • MIRENA IUS (Intrauterine System): A T-shaped intrauterine device containing progesterone hormones. Highly recommended for older women, reducing menstrual blood loss by almost 70-90%.
  • Hysterectomy: Removal of the uterus is a last-resort option if other treatments prove ineffective.

Understanding DUB empowers women to make informed decisions about their reproductive health, promoting timely diagnosis and appropriate medical intervention.

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