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Alternative Names Return to topAnovulatory bleeding; Bleeding - dysfunctional uterine; DUB; Abnormal uterine bleeding
Definition Return to top
Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the vagina that is not due to a physical (anatomical) cause.
Causes Return to top
DUB may be caused by an imbalance of hormones -- estrogen or progesterone.
Risk factors include:
DUB occurs in women during their reproductive years (they have started their period but have not reached menopause). About 20% of DUB cases occur in adolescents and 40% occur in women over 40.
Symptoms Return to top
Exams and Tests Return to top
Dysfunctional uterine bleeding (DUB) is diagnosed after all other causes of abnormal uterine bleeding are ruled out. This includes:
The health care provider will do a pelvic examination.
Tests usually include:
The following procedures may be done:
Treatment Return to top
Young women within a few years of their first period are not treated unless symptoms are very severe, such as heavy blood loss causing anemia.
In other women, the goal of treatment is to control the menstrual cycle. Oral birth control pills or progestogen therapy are often used for this purpose. Women with anemia may get iron supplements.
If you want to get pregnant, you may be given medication to stimulate ovulation.
Women whose symptoms are severe and resistant to medical therapy may need surgical treatments including:
Older women who may be getting close to menopause may receive hormones or surgery to relieve symptoms.
Outlook (Prognosis) Return to top
Hormone therapy usually relieves symptoms.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you have unusual vaginal bleeding.
References Return to top
Rakel P, ed. Conn’s Current Therapy 2005. 57th ed. Philadelphia, Pa: WB Saunders; 2005:1286-1288.
Stenchever A, et al. Comprehensive Gynecology. 4th ed. St. Louis, Mo: Mosby; 2001:1082-1084.
Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007.Update Date: 2/5/2008 Updated by: Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.