Dysfunctional Uterine Bleeding (DUB)

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• QHow is dysfunctional uterine bleeding treated?

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  A Sigma Nursing answered

  Because dysfunctional uterine bleeding is caused by an abnormal amount of hormones, medication used to treat DUB works by regulating the body's hormones. Birth control pills use a combination of estrogen and a progestin to regulate the hormones related to menstruation. These help make periods lighter and more regular. These hormones can also be injected or used in an intrauterine device (IUD). Ibuprofen or another nonsteroidal anti-inflammatory medication taken just before the beginning of the period may also help.

  Some lifestyle changes can also help with menstrual bleeding. Women who eat healthily and sleep well have better periods. Also, avoid aspirin because that can add to problems related to blood clotting. An iron supplement may help prevent symptoms of anemia.

  Doctors do not usually perform hysterectomies as a treatment for dysfunctional uterine bleeding on younger women. The results are severe; a woman no longer gets her period and cannot have children. For this reason, it is only done as a last resort on younger women and is done most often on women during menopause.

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• QShould I talk to my doctor about my DUB symptoms?

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  A Sigma Nursing answered

  Women with dysfunctional uterine bleeding (DUB) experience irregularly timed periods (less than 28 or more than 35 days apart) with occasional bleeding in between periods. Vaginal bleeding during the period is often heavier than normal and lasts more than the normal period length of seven days. Excessive blood loss can lead to fatigue and anemia. Beyond the menstrual cycle, women will experience symptoms of irregular hormone levels. This includes body hair growth and mood swings.

  Irregular periods are expected when a young woman starts her period or when a woman is about to enter menopause, but abnormal bleeding like this can have a number of causes. Talk to your doctor if your DUB symptoms are disruptive to your everyday life. Hormonal treatment can make DUB more manageable. It is also important to go to the doctor if you think you are at risk for endometrial cancer. Risk factors for endometrial cancer include women over the age of 40 (especially between ages 60-70), obesity, diabetes, high blood pressure, a history of irregular periods, polycystic ovary syndrome, gallbladder disease, never having been pregnant, and problems related to the uterine lining that your doctor can find through various imaging examinations.

• QWhat causes dysfunctional uterine bleeding?

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  A Sigma Nursing answered

  Dysfunctional uterine bleeding (DUB) is caused by abnormal levels of the hormone estrogen. In women with normal periods, the high level of estrogen decreases after releasing an egg. With dysfunctional uterine bleeding, the egg is not always released and the woman's uterine lining sheds irregularly. Other causes of hormone imbalance, including thyroid problems and some medication, can also cause DUB.

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• QWhat is dysfunctional uterine bleeding?

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  A Sigma Nursing answered

  Dysfunctional uterine bleeding (DUB) is an excessive vaginal bleeding that is abnormal to the menstrual cycle. Bleeding occurs either more or less frequently than is typical for menstruation and the bleeding may be significantly thicker and heavier than it should be. It is also possible that bleeding could occur very frequently and be present in between periods. The changes in bleeding are caused by irregular hormones. These irregularities are usually treatable by hormones, and in some instances surgical methods will be used.

  Dysfunctional uterine bleeding is common, especially among women whose periods are irregular. This includes women who have just begun or are ending their periods. DUB is one of the more common reasons why a woman would go see her doctor. Approximately 1 in 19 US women ages 18-50 report menstrual problems annually.

  Some women bleed so heavily with DUB that additional medical care may be necessary. Many women have difficulties containing heavy bleeding with sanitary pads and tampons. These problems can usually be fixed through hormonal therapy. For severe bleeding, some women require intravenous estrogen and fluids and occasionally a blood transfusion. See your doctor if you are concerned about your heavy bleeding.

  Some thyroid and hormone disorders can cause DUB. Hypothyroidism, for example, can prevent the ovaries from releasing an egg; this causes the hormones to remain high later in the menstrual cycle. Other illnesses can affect treatment—women with heart or blood vessel disorders or who are at high risk for heart disorders are not usually given birth control pills for treatment. The cycle of abnormal thickening and irregular shedding associated with dysfunctional uterine bleeding can cause precancerous cells to develop.

  DUB is very treatable. It is important, however, that you go to your doctor to see if you have any complications.

• QWhat do I need to know about caring for someone with DUB?

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  A Sigma Nursing answered

  Twenty percent of women with dysfunctional uterine bleeding are adolescents. Over 50 percent of women with DUB are over the age of 45. Adolescents often grow out of dysfunctional uterine bleeding. The beginning of young woman's period is often irregular and then become regular after some time. Other adolescents, though, may require treatment to deal with severe and disruptive symptoms. Because dysfunctional uterine bleeding can occur at any time in a woman's child bearing years, many older women experience symptoms. Adolescents are less frequently treated when the period is not disruptively heavy and the doctor thinks she will grow out of the disorder soon. Women with severe symptoms can be treated with NSAIDs, birth control pills or other hormonal methods. If these methods don't help and they no longer want to have children, they may consider a hysterectomy or other surgical procedure.

  When caring for someone with dysfunctional uterine bleeding, be aware of symptoms of the disorder. Be sensitive to mood swings, which are a symptom of irregular hormones, and remember that fatigue is problem associated with excessive bleeding. Anemia can be a serious side effect and require iron treatment. Make sure the person takes all medications as prescribed. If the person is having problems because of infertility related to the condition, be sensitive to the emotional stress this may be placing her under.

• QWhen should I call my doctor about abnormal vaginal bleeding?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  

  It is recommended that you call your doctor about bleeding that is heavy, prolonged, or between periods; bleeding accompanied by an odor, discharge, or severe pain; or bleeding or spotting during a pregnancy or suspected pregnancy. Watch Dr. Oz talk about abnormal bleeding and endometrial cancer.
  
  
  

  

  Find out more about this DVD:

  Do I Need to Be Worried About Vaginal Bleeding with a Discharge?
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• QIs there a cure for dysfunctional uterine bleeding?

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  A Portsmouth Regional Hospital answered

  Dysfunctional uterine bleeding can be treated completely through hormone therapy in most cases. Some people may require removal of the lining of the uterus to fix heavy bleeding, either through dilation and curettage or endometrial ablation. Rarely, people may require a hysterectomy to completely remove the uterus. Because of the serious results of this surgery, such as infertility, it is no longer used as often as it was in the past and is usually only used with menopausal women. Anemia is a possible complication, but this can be treated through iron supplements.
• QHow should I prepare for an appointment to diagnose DUB?

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  A Portsmouth Regional Hospital answered

  To prepare for a doctor's appointment about dysfunctional uterine bleeding, it would be helpful to make a list of your symptoms, even if they don't seem relevant (they may include hot flashes, mood swings, or fatigue). Some doctors recommend a diary of your bleeding that makes note of the date and how heavy your bleeding was that day. Your doctor would also benefit from knowing your diet and other medications that you are on. Prepare a list of questions you have for the doctor, including treatment options, diagnostic tests, and other symptoms of which you should be aware.
• QHow is dysfunctional uterine bleeding diagnosed?

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  A Portsmouth Regional Hospital answered

  Before diagnosing dysfunctional uterine bleeding, your doctor will want to rule out other causes of excessive bleeding like pregnancy and blood clotting problems. Then the doctor will determine whether or not you have dysfunctional uterine bleeding by doing a pelvic exam and a number of laboratory tests to check blood counts, hormone functioning, and anemia. If you are at high risk for developing endometrial cancer, the doctor may also to a biopsy of your uterine lining. Other tests may include transvaginal ultrasonography and hysteroscopy, if needed.
• QHow does dysfunctional uterine bleeding affect pregnancy?

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  A Portsmouth Regional Hospital answered

  Dysfunctional uterine bleeding can affect your ability to become pregnant. 90% of women with dysfunctional uterine bleeding do not regularly ovulate, and therefore have great difficulty trying to get pregnant. If you wish to become pregnant and have dysfunctional uterine bleeding, your doctor may prescribe you with fertility drugs to induce ovulation and different methods of treatment for DUB may be used.