MODERN MANAGEMENT OF DYSFUNCTIONAL UTERINE BLEEDING

Abstract

Dysfunctional uterine bleeding is defined as abnonnal uterine bleeding from the uterus in the absence of organic disease in the genital tract .

Dysfunctional uterine bleeding can be classified into primary and secondary types . Primarv DUB : when there is no detectable disease in the genital tract or else where is the body . Secondary DUB : cases with no detectable genital cause, but there is known extra genital disorder causing this bleeding ex. coagulation, hepatic or renal disorders.

Also cases associated with the use of contraceptives as IUCD. oral or injectable contraceptives or other drugs as salicylates _anticoagulants.

DUB is observed in both ovulatory and anovulatory cycles .

The diagnosis of DUB is made by exclusion of organic disease of the genital tract or systemic disease .

To establish a _diagnosis of DUB it is essential to take full gynecological and medical history and to assess through general and pelvic examination .A full menstrual history , including the length of the menstrual intervals and the volume of the menstrual blood loss , should be taken . A subjective measurement of the degree of blood loss, either in tenns of days of bleeding or the amount of sanitary protection required , is in adequate to diagnose excessive blood loss.