Abnormal uterine bleeding (AUB) affects women of all ages and is the commonest reason woman to seek gynecological advice.1 From a healthcare point of view, it is also associated with high direct and indirect costs. Symptoms of AUB frequently co-exist with fibroids.1 The relationship between them, however, is not totally understood. In many women, fibroids may be an incidental innocent bystander in the underlying causes of a menstrual bleeding complaint.2
In some circumstances, AUB may even mask a (pre)cancerous uterine condition and therefore always justifies a detailed evaluation.2
The following definitions describe menstrual patterns associated with AUB:
You may be asked to undergo some tests to find out the definitive cause of these symptoms, which may be related to various gynecological conditions.
These tests include:
This type of procedure should be performed only under visualization. Since it is many times still performed blindly, it is recommended to perform it using an endoscope as the accuracy of the procedure is much higher and a false diagnosis can be avoided.10,11
1. Clark TJ, Middleton LJ, Cooper NAM, et al. A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding. Health Technology Assessment, No. 19.61. NIHR Journals Library; 2015 Jul.
2. L Whitaker et. Al. Abnormal uterine bleeding, Best Practice & Research Clinical Obstetrics & Gynaecology Volume 34, July 2016, Pages 54-65
3. Oligomenorrhea: Definition, Signs, and Treatments. (2021, June 30). WebMD. https://www.webmd.com/women/oligomenorrhea-definition-signs-and-treatments
4. Young, B. (2018, February 28). Polymenorrhea. Healthline. https://www.healthline.com/health/polymenorrhea
5. Oehler, M. K., & Rees, M. C. P. (2003). Menorrhagia: an update. Acta Obstetricia et Gynecologica Scandinavica, 82(5), 405–422. https://doi.org/10.1034/j.1600-0412.2003.00097
6. Ellis, M. E. (2019, September 23). Vaginal Bleeding Between Periods. Healthline. https://www.healthline.com/health/vaginal-bleeding-between-periods
7. Christiano, D. (2019, March 8). Everything You Should Know About Menometrorrhagia. Healthline. https://www.healthline.com/health/womens-health/menometrorrhagia
8. NHS website. (2021, November 18). Postmenopausal bleeding. Nhs.Uk. https://www.nhs.uk/conditions/post-menopausal-bleeding/
9. Pitkin J. Dysfunctional uterine bleeding. BMJ. 2007 May 26;334(7603):1110-1. doi: 10.1136/bmj.39203.399502.BE. PMID: 17525454; PMCID: PMC1877895.
10. Epstein E, Ramirez A, Skoog L, Valentin L. Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstet Gynecol Scand. 2001;80(12):1131–1136.
11. Bettocchi S, Ceci O, Vicino M, Marello F, Impedovo L, Selvaggi L. Diagnostic inadequency of dilation and curettage. Fertil Steril. 2001;75(4):803–805.