Dysfunctional uterine bleeding natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | |||
{{Dysfunctional uterine bleeding}} | {{Dysfunctional uterine bleeding}} | ||
{{CMG}} {{AE}} | {{CMG}}; {{AE}} [[User:AroojNaz|Arooj Naz, M.B.B.S]] | ||
==Overview== | ==Overview== | ||
[[Dysfunctional uterine bleeding]] is an irregularity of the [[menstrual cycle]] that may affect the duration, frequency and blood volume. Normal cycles last around 24-38 days and average 5-80 mL of blood loss during this time. Commonly associated complications include [[infertility]], [[anemia]] and the possibility of underlying [[Endometrial cancer|endometrial malignancy]]. Generally, the prognosis is favourable, but may depend on underlying causes and treatment options. The amount of blood loss varies according to [[hormonal]] and [[non-hormonal]] medications, as well as with [[surgical]] interventions. | |||
==Natural History== | |||
Dysfunctional uterine bleeding is a commonly presenting symptom and is defined as any irregularity of the [[Menstrual cycle|menstrual cycl]]<nowiki/>e. This can include the duration, frequency and blood volume. It most commonly presents in women that have undergone [[menarche]] but are still perimenopausal. This is usually between the ages of 15-49. Each cycle often lasts around 24-38 days, with an average of 5-80 mL of blood loss.<ref name="pmid30422508">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30422508 | doi= | pmc= | url= }} </ref> | |||
==Complications== | |||
The effect on a woman's lifestyle is one of the most important complications that patients face. Generally, the associated [[abdominal pain]] and unexpected [[bleeding]] can greatly affect one's lifestyle. | |||
===Other complications include:=== | |||
*[[Infertility]]: this complication may be the time when many women actually get diagnosed with [[endometriosis]] | |||
*[[Anemia]]: severe anemia may lead to death and is important to manage early on | |||
*[[Endometrial cancer|Endometrial malignancy]]: it is important to rule out endometrial malignancy, as this can be one of the underlying causes of [[Dysfunctional uterine bleeding|DUB]]. An [[endometrial biopsy]] is helpful in diagnosing the condition | |||
==Prognosis== | |||
The prognosis is generally favourable, but it may be altered depending on the underlying cause as well as the treatment modality.<ref name="pmid30422508">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30422508 | doi= | pmc= | url= }} </ref> | |||
*Blood loss may be reduced up to 50% in patients taking a combination of non-hormonal medications with [[NSAIDs]] | |||
*Up to 50%-90% of blood loss may be reduced in patients that use [[Progesterone|injectable progesterone]] and [[GnRH analog|GnRH agonists]], such as [[leuprolide]] | |||
*Surgical interventions such as [[hysterectomy]] have shown better results in 1 year when compared to non-surgical treatment recipients | |||
*The recurrence rate of polyps can be significantly reduced after combining a hysteroscopic [[polypectomy]] with the insertion of a [[Levonorgestrel IUD|levonorgestrel intrauterine device]] or [[endometrial ablation]]. It's [[recurrence rate]] is around 2%-3%. <ref name="pmid32491756">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=32491756 | doi= | pmc= | url= }}</ref> | |||
*Patients with [[leiomyoma]] can have varying outcomes. While many remain asymptomatic, whereas some may continue to experience symptoms depending on [[fertility]] desires and the associated [[hormonal exposure]].<ref name="pmid30855861">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30855861 | doi= | pmc= | url= }}</ref> | |||
*The prognosis for [[Endometrial cancer|endometrial malignancy]] is relatively poor, especially for African women in which the prognosis is worse. Mortality rates have increased 100% in the last 20 years with an overall 5 year survival rate of 80%.<ref name="pmid32965984">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=32965984 | doi= | pmc= | url= }}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Gynecology]] | [[Category:Gynecology]] |
Latest revision as of 00:22, 19 March 2022
Dysfunctional uterine bleeding Microchapters |
Differentiating Dysfunctional uterine bleeding from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Dysfunctional uterine bleeding natural history, complications and prognosis On the Web |
American Roentgen Ray Society Images of Dysfunctional uterine bleeding natural history, complications and prognosis |
FDA on Dysfunctional uterine bleeding natural history, complications and prognosis |
CDC on Dysfunctional uterine bleeding natural history, complications and prognosis |
Dysfunctional uterine bleeding natural history, complications and prognosis in the news |
Blogs on Dysfunctional uterine bleeding natural history, complications and prognosis |
Directions to Hospitals Treating Dysfunctional uterine bleeding |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Dysfunctional uterine bleeding is an irregularity of the menstrual cycle that may affect the duration, frequency and blood volume. Normal cycles last around 24-38 days and average 5-80 mL of blood loss during this time. Commonly associated complications include infertility, anemia and the possibility of underlying endometrial malignancy. Generally, the prognosis is favourable, but may depend on underlying causes and treatment options. The amount of blood loss varies according to hormonal and non-hormonal medications, as well as with surgical interventions.
Natural History
Dysfunctional uterine bleeding is a commonly presenting symptom and is defined as any irregularity of the menstrual cycle. This can include the duration, frequency and blood volume. It most commonly presents in women that have undergone menarche but are still perimenopausal. This is usually between the ages of 15-49. Each cycle often lasts around 24-38 days, with an average of 5-80 mL of blood loss.[1]
Complications
The effect on a woman's lifestyle is one of the most important complications that patients face. Generally, the associated abdominal pain and unexpected bleeding can greatly affect one's lifestyle.
Other complications include:
- Infertility: this complication may be the time when many women actually get diagnosed with endometriosis
- Anemia: severe anemia may lead to death and is important to manage early on
- Endometrial malignancy: it is important to rule out endometrial malignancy, as this can be one of the underlying causes of DUB. An endometrial biopsy is helpful in diagnosing the condition
Prognosis
The prognosis is generally favourable, but it may be altered depending on the underlying cause as well as the treatment modality.[1]
- Blood loss may be reduced up to 50% in patients taking a combination of non-hormonal medications with NSAIDs
- Up to 50%-90% of blood loss may be reduced in patients that use injectable progesterone and GnRH agonists, such as leuprolide
- Surgical interventions such as hysterectomy have shown better results in 1 year when compared to non-surgical treatment recipients
- The recurrence rate of polyps can be significantly reduced after combining a hysteroscopic polypectomy with the insertion of a levonorgestrel intrauterine device or endometrial ablation. It's recurrence rate is around 2%-3%. [2]
- Patients with leiomyoma can have varying outcomes. While many remain asymptomatic, whereas some may continue to experience symptoms depending on fertility desires and the associated hormonal exposure.[3]
- The prognosis for endometrial malignancy is relatively poor, especially for African women in which the prognosis is worse. Mortality rates have increased 100% in the last 20 years with an overall 5 year survival rate of 80%.[4]