Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Case Series Volume 3 Issue 8

Abnormal Uterine Bleeding

K Siva Achanna and Jaydeep Nanda*

Mahsa University, Jalan SP2, Kuala Langat, Selangor, Malaysia

*Corresponding Author: Jaydeep Nanda, Mahsa University, Jalan SP2, Kuala Langat, Selangor, Malaysia.

Received: July 02, 2021; Published: July 31, 2021

Abstract

the attention of the primary care doctor or the gynaecologist. Anovulation without any medical illness or pelvic pathology seems to be the common cause.

Bleeding due to a wide variation in pathology both inside and outside the reproductive tract can be termed as an anovulatory bleeding. Therefore, it is mandatory to elicit a focused menstrual history and appropriate evaluation followed by a pelvic examination. This includes a vaginal speculum examination, to differentiate anovulatory bleeding from other causes of bleeding. In contrast, Heavy menstrual bleeding (HMB) is referred to as an ovulatory bleeding exceeding 8 days duration and is often caused by uterine fibroids or adenomyosis, a copper IUD or coagulation disorders. PALM-COEIN classification is a system designed by the Federation Internationale de Gynecologie et d’ Obstetrique to define the precise underlying causes of AUB.

Etiology of AUB can be classified as following the Acronym “PALM-COEIN”: Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic and Not otherwise classified.

AUB describes a range of symptoms, such as HMB, inter menstrual bleeding (IMB) and a combination of both heavy and prolonged menstrual bleeding (MB). Dysfunctional uterine bleeding (DUB) and menorrhagia are now better described as AUB. Newborn girls sometimes spot for a few days after birth, due to placental estrogenic stimulation of the endometrium in utero.

Keywords: Abnormal Uterine Bleeding, Historical Views of Menstruation, Female Genital Tract Pathology, Bleeding Disorders (Thrombophilia), Pharmacological Treatment, Minimally Invasive Surgical Procedures

References

  1. Liu Z., et al. “A systemic review evaluating health related quality of life, work impairment and health-care costs and utilization in abnormal uterine bleeding”. Value Health 3 (2007): 183-194.
  2. Shaplay M., et al. “An epidemiological survey of symptoms and menstrual loss in the community”. British Journal of General Practice 502 (2004): 359-363.
  3. Munro MG., et al. “The two FIGO systems for normal and abnormal symptoms and classification of causes of abnormal uterine bleeding in the reproductive years. 2018 revisions”. International Journal of Gynecology and Obstetrics3 (2018): 393-308.
  4. Munro MD., et al. “FIGO classification system (PALM COEIN for causes of abnormal uterine bleeding in nongravid women of reproductive age”. International Journal of Gynecology and Obstetrics 113 (2011): 3-13.
  5. Fraser IS., et al. “The FIGO recommendations on terminologies and definitions for and abnormal uterine bleeding”. Seminars in Reproductive Medicine 5 (2011): 383-390.
  6. Delfin Tan., et al. “Cultural aspects and mythologies surrounding menstruation and abnormal uterine bleeding”. Best Practice and Research: Clinical Obstetrics and Gynaecology 40 (2017): 121-133.
  7. Cattanach J. “Estrogen deficiency after tubal ligation”. Lancet 131 8Eu483 (1985): 847-849.
  8. Euling SY., et al. “Examination of US-puberty timing data from 1940-1994for secular trends: Panel findings”. Pediatrics 121 (2008): S172-219.
  9. Fritz MA and Speroff L. “Abnormal uterine bleeding 2012”. In Clinical Gynecologic Endocrinology and Infertility. 8th Wolters Kluwer, Lippincott Williams and Wilkins (2012): 591-619.
  10. Haynes PJ., et al. “Patterns of menstrual blood loss in menorrhagia”. Research and Clinical Forums I (1979): 73-78.
  11. Kaunitz AM. “Abnormal Uterine Bleeding in Reproductive Age Women”. JAMA 21 (2019): 2126-2127.
  12. Dubinsky T., et al. “Role of transvaginal sonography and endometrial biopsy in the evaluation of dysfunctional uterine bleeding in premenopausal women”. Journal of Clinical Ultrasound 280 (1998): 1510.
  13. deVries LD., et al. “Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in premenopausal women with abnormal uterine bleeding”. Journal of Clinical Ultrasound 28 (2000): 217-223.
  14. Lindheim SR., et al. “Operative hysteroscopy in the office setting”. Journal of the American Association of Gynecologic Laparoscopists 7 (2000): 65.
  15. Fraser IS and Kovacs GT. “The efficacy of non-contraceptive uses for hormonal contraception”. Medical Journal of Australia12 (2003): 621-623.
  16. Bitzer G., et al. “Medical management of Heavy Menstrual Bleed. A comprehensive review of literature”. Obstetrical and Gynecological Survey 2 (2015): 115-130.
  17. Aksu F., et al. “Oral medroxy progesterone acetate for the treatment of dysfunctional uterine bleeding in 24 adolescent”. Australian and New Zealand Journal of Obstetrics and Gynaecology 37 (1997): 228.
  18. Cohen BJB, Gibor Y. “Metabolic and endocrine effects of medicated intra-uterine device”. In Benagiano G, Diczfalusy E (eds) Endocrine mechanism in fertility regulation. New York: Raven Press 71-124.
  19. Nilsson CM and Solyell L. “Clinical studies on oral contraceptives-a randomized, double blind, crossover study of four different preparations”. Acta Obstetricia et Gynecologica Scandinavica (1967): 1-31.
  20. Fergusson RJ., et al. “Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database Systemic Review (2013): CD 000329.
  21. Fraser IS., et al. “Efficacy of mefenamic acid in patients with a complaint of menorrhagia”. Obstetrics and Gynecology 58 (1981): 543-551.
  22. Hall P., et al. “Control of menorrhagia by the cyclo-oxygenase inhibitors naproxen sodium and mefenamic acid”. British Journal of Obstetrics and Gynecology 94 (1987): 554-558.
  23. Coulter A., et al. “Testing menorrhagia in primary care. An overview of drug trials and a survey of prescribing practice”. International Journal of Technology Assessment in Health Care 11 (1995): 456-471.
  24. Milsom I., et al. “A comparison of flubiprofen, tranexamic acid and a levonorgestrel- releasing intrauterine contraceptive device in the treatment of idiopathic menorrhagia”. American Journal of Obstetrics and Gynecology 164 (1991): 879-883.
  25. Chimbira TH., et al. “Reduction in menstrual blood loss by danazol in unexplained menorrhagia. A lack of effects of placebo”. British Journal of Obstetrics and Gynecology 87 (1980): 1152-1158.
  26. Sowter MC., et al. “Pre-operative endometrial thinning agents before endometrial destruction for heavy menstrual bleeding”. Cochrane Database of Systemic Reviews (2002): CD001124.
  27. Cameron IT., et al. “The effects of danazol, mefenamic acid, norethisterone and a progesterone impregnated coil on endometrial prostaglandin concentrations in women with menorrhagia”. Prostaglandins 34 (1987): 99-110.
  28. Kouides PA., et al. “Multisite management study of menorrhagia with abnormal laboratory haemostasis. A prospective crossover study of intranasal desmopressin and oral tranexamic acid”. British Journal of Haematology2 (2009): 212-220.
  29. Harrison RF and Cambell S. “A double-blind trial of ethamsylate in the management if primary and intrauterine-device menorrhagia”. Lancet7980 (1976): 283-285.
  30. Anderson JK and Rybo G. “The levonorgestrel releasing intrauterine contraceptive device in the management of menorrhagia”. British Journal of Obstetrics and Gynecology 102 (1995): 401-416.
  31. Lower AM. “Laparoscopic myomectomy”. In, Progress in Obstetrics and Gynaecology Studd J (ed), Churchill Livingstone 15 (2003): 381-88.
  32. Goldrath M., et al. “Laser photo vaporization of endometrium for the treatment of menorrhagia”. American Journal of Obstetrics and Gynecology 140 (1988): 14-19.
  33. Downes E and O’Donovan P. “Microwave endometrial ablation is the management of menorrhagia”. Current Opinion on Obstetrics and Gynecology 12 (2000): 293-296.
  34. Magos AL., et al. “Absorption of irrigating solution during transcervical resection of endometrium”. British Medical Journal 300 (1990): 1079.

Citation

Citation: K Siva Achanna and Jaydeep Nanda. “Abnormal Uterine Bleeding”. Acta Scientific Women's Health 3.8 (2021): 77-87.

Copyright

Copyright: © 2021 K Siva Achanna and Jaydeep Nanda. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US