Abnormal Menstrual Cycle & Uterine Bleeding

Abnormal Uterine Bleeding (AUB) refers to uterine bleeding that falls outside the normal ranges for menstrual flow, frequency, cycle, or duration. AUB can arise from various causes, including pregnancy, endocrine issues, hormonal imbalances, clotting disorders, endometriosis, fibroids, or polyps. Treatment depends on the cause and may involve medication, hormone therapy, or surgery.

Dysfunctional Uterine Bleeding (DUB) refers to abnormal uterine bleeding caused by hormonal imbalance and not due to structural abnormalities within the uterus (already ruled out through diagnostic exclusion). This condition is common in women approaching menopause and young women who have just started menstruating. Treatment options may include hormonal therapy, such as birth control pills, to regulate the menstrual cycle or surgical intervention in more severe cases.

Ovulatory DUB refers to abnormal uterine bleeding related to the ovulation process. This condition can occur when a woman's ovulation cycle is disrupted, leading to hormonal imbalances. It may result from the body's failure to ovulate normally during the menstrual cycle, affecting hormone levels related to menstruation and causing abnormal bleeding. Treatment typically involves restoring hormonal balance, possibly including hormone therapy or other methods to regulate the menstrual cycle.

Anovulatory DUB refers to abnormal uterine bleeding caused by the absence of ovulation. This condition is often associated with hormonal imbalances because a regular menstrual cycle requires ovulation to trigger related hormonal changes. When ovulation does not occur, it can lead to irregular or abnormal bleeding. Treatment methods may include hormone replacement therapy or other interventions to restore a regular menstrual cycle and reduce abnormal bleeding.

In medicine, the diagnosis of menstrual irregularities and abnormal uterine bleeding involves the following steps:

1. Understanding the pattern and nature of the bleeding through a detailed medical history.
  
2. Conducting a physical examination, especially a pelvic exam. Laboratory tests that may be required include hormone level measurements. Imaging studies such as ultrasound or MRI may be performed to detect possible structural abnormalities.
Common diagnostic tests include:

• Blood tests: Haemoglobin
• Pregnancy test
• Cervical smear test
• Endometrial biopsy
• Ultrasound
• Hysteroscopy ± Endometrial biopsy

3. For the diagnosis of dysfunctional uterine bleeding, ovulatory or anovulatory dysfunctional uterine bleeding, the appropriate diagnostic and treatment methods are chosen based on the patient's specific circumstances.