Dysfunctional uterine bleeding
Dysfunctional uterine bleeding
Updated: 12/22/2021
© Jun Wang, MD, PhD
General features
- Definition: Bleeding >5 days of unknown cause in women of childbearing age
- Clinical, NOT pathology term
- Ovulate or anovulatory
- Anovulatory most common
Commonly due to endocrine disorders, such as polycystic ovary disease, ovarian failure, metabolic disorders, etc
Higher risk for endometrial hyperplasia and
carcinoma due to unbalanced estrogen effect
Key pathogenesis
- Abnormal hormonal function
- Ovulatory: inadequate proliferative phase, inadequate secretory phase, irregular shedding or membranous dysmenorrhea
- Anovulatory: unbalanced estrogen effects, proliferative endometrium during chronological secretory phase, risk of adenocarcinoma of endometrium
Key pathological findings
- Uneven differentiation of glands and stroma in a cycle, for example, mixed proliferative and secretory phase glands in a proliferative phase stroma
Treatment
- Underlying causes
- Rule out other causes of abnormal bleeding: chronic inflammation, ectopic pregnancy, abnormal endometrial growth (benign and malignant), atrophy, etc
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