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Dysfunctional Uterine Bleeding – Symptoms, Pathophysiology & Treatment

What is Anovulatory Dysfunctional Uterine Bleeding?

Dysfunctional Uterine Bleeding 218x300 Dysfunctional Uterine Bleeding – Symptoms, Pathophysiology & Treatment Dysfunctional uterine bleeding is characterized by abnormal uterine bleeding without the disease of the organ. Dysfunctional uterine bleeding is the most typical etiology of abnormal vaginal bleeding throughout a woman’s reproductive days. Dysfunctional uterine bleeding can have an effect on the woman’s physical, social and financial life.

Signs and Symptoms

A woman suffering from dysfunctional uterine bleeding may observe the following signs and symptoms:

  1. Vaginal bleeding between menstrual periods
  2. Menstrual periods may become lower than 29 days or above 35 days in interval
  3. The time between menstruation can be altered with every cycle
  4. Vaginal bleeding is more severe

large clots may appear

there will be a need to change the pad or tampon throughout the night

the pad or the tampon will be soaked every two to three hours

Vaginal bleeding will persists for more days than average or above seven days

Other signs and symptoms may include:

  1. Overgrowth of body hair or hirsutism
  2. Hot sensations
  3. Mood changes
  4. Vaginal pain and dryness
  5. Fatigue and tiredness
  6. Anemia from losing excessive blood

Causes

The menstrual period will be different in each woman. Generally the menstrual period happens every 28 days and usually persists for four to seven days.

The menstrual period of teenage girls who are just having their early cycles usually have 21 to 45 days interval. Whereas women 40 years old and above usually observe that they have less usual menstrual periods.

Throughout the normal menstrual period, numbers of various female hormones produced by your body increase and decrease. Estrogen and progesterone are two very significant female hormones.

Ovulation is the division of the normal menstrual period when the ovum is discharged from the ovaries. The most typical etiology of dysfunctional uterine bleeding is when your ovaries do not discharge an ovum. When this happens, the number of hormones inside your body is not the same, resulting to menstrual irregularities.

Other modifications and imbalances in your hormones may also lead to menstrual changes.

Pathophysiology

The usual menstrual period is 28 days on the first day of menstruation. Throughout the first 14 days called the follicular stage of the menstrual period, the uterine wall thickens because of estrogen. In reaction to increasing levels of estrogen, the pituitary gland releases follicle stimulating hormone or FSH and luteinizing hormone or LH, which promotes the discharge of an egg in the middle of the cycle. The remains of the follicular capsule will become the corpus luteum.
Following the ovulation, the luteal stage starts and it is marked by the stimulation of progesterone released from the corpus luteum. Progesterone develops the uterine wall and makes it more approachable to implantation. If implantation does not happen, without the hCG or human chorionic gonadotropin, the corpus luteum will perish together with sudden decrease in progesterone and estrogen. Sudden drop of these hormones will result to vasoconstriction of the uterine wall arteries. This will result to menstruation which happens about 14 days following ovulation when the uterine wall becomes ischemic and falls off.

The following are medical terms usually applied to define abnormal uterine bleeding:

Menorrhagia

-prolonged or severe menstrual flow happening regularly

-more than seven days or more than 80 ml every day

Metrorrhagia - menstrual flow happening at irregular intervals. menstrual periods more frequent than usual

Menometrorrhagia - prolonged or severe menstrual flow happening irregularly. Menstrual periods more frequent than usual

Intermenstrual bleeding - menstrual flow of different quantities happening between regular menstrual cycle

Midcycle spotting - bleeding happening just before ovulation, usually as a result of decreasing estrogen

Postmenopausal bleeding - return of menstrual flow in menopausal women minimum of six months to one year following termination of menstruation

Amenorrhea - absence of menstrual bleeding for six months or above

Anovulatory dysfunctional uterine bleeding came from a problem of the hypothalamus, pituitary and ovaries and specifically usual at the utmost of the reproductive days. As soon as ovulation does not happen, no progesterone is created to steady the uterine wall; therefore, proliferative uterine wall continues. Bleeding periods become uneven, and amenorrhea, metrorrhagia, and menometrorrhagia are usual. Bleeding from anovulatory dysfunctional uterine bleeding is believed to come from alterations in prostaglandin strength, intensified uterine wall reactions to prostaglandins, and alterations in uterine walls’ vascular makeup.

Treatment

Young girls during their early years of first menstrual flow are usually not treated except if symptoms are very extreme such as profuse bleeding that can cause anemia.

In some girls, the aim of the treatment is to manage the menstrual period.

  1. Oral contraceptives are usually prescribed
  2. An IUD that gives progestin can be very beneficial for severe blood flow and pain

The doctor may suggest iron supplements to treat anemia. If you wish to get pregnant, you may be prescribed with drugs to increase ovulation.

Severe symptoms and those that do not react to medications may need surgery involving:

Endometrial ablation - removing the uterine wall to stop or decrease the bleeding

Hysterectomy - surgical removal of uterus. It is rarely performed

D and C - for removal of polyps & confirmation purposes

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December 9, 2011 This post was written by Categories: Medical Tagged with:
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