Abnormal uterine bleeding is the most common presenting problem in gynaecology. Dysfunctional uterine bleeding (DUB) is defined as the unusual bleeding from uterine in absence of organic disease. During women’s reproductive periods, DUB is the leading cause of abnormal vaginal bleeding. Substantial Dub may have financial and quality of life burden. It affects social and mental health of woman.
Pathophysiology of abnormal or dysfunctional uterine bleeding:
The normal course of menstrual cycle is 28 days and starts on the first day of menses. During the follicular phase (first 14 days) of the menstrual cycle, endometrium becomes thick under the influence of oestrogen. In reply to rising oestrogen stages, follicle-stimulating hormone (FSH) and specially Latinizing hormones (LH) are secreted by pituitary gland that stimulates the release of an ovum at the midpoint of the cycle. The remaining follicular capsule forms the corpus luteum.
Dysfunctional Uterine Bleeding
After ovulation, luteal phase starts and is typified by secretion of progesterone from the corpus luteum. Progesterone matures the lining of the uterus and makes it more amenable to implantation. If implantation does not take place, the corpus luteum dies, in the nonexistence of human chorionic gonadotropin (HCG) accompanied by sudden falls in levels of progesterone and estrogen. Hormone withdrawal produces vasoconstriction in the spiral arterioles of the endometrium. This results in menses, which occurs about 14 days after ovulation when the ischemic endometrial lining becomes necrotic.
Terms commonly used to express abnormal uterine bleeding are given below:
