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Treatment of Dysfunctional Uterine Bleeding

Dysfunctional Uterine Bleeding (DUB) is defined as irregular bleeding in the absence of any uterine or pelvic disease.  There are 2 types of DUB depending on the age it presents

  • Anovular DUB occurs in 2 extreme age groups namely adolescence (just as periods has started at menarche) or peri-menopause (just as periods is about to end at menopause).  The cause is due to hormonal changes during this period of time
  • Ovular DUB is found in women between 35-45 years old due to an organic cause such as defective corpus luteum formation or reproductive tract disease

Click to view JeanHailes video on Heavy Periods

Management

Do keep a diary of your bleeding and non-bleeding days and take note of how heavy your flow was and how much sanitary pads or tampons you needed to control it on a single day.  ALL cases of heavy menstrual bleeding should be seen by a gynaecologist so that you can get a thorough check up and get some of these tests done.

  • Blood tests (to check for anaemia or clotting disorders)
  • Hysteroscopy
  • Cervical Cancer Screening test (Pap smear)
  • Tissue biopsy (to exclude cancer)
  • Ultrasound scan

Treatment

Treatment depends on many factors (such as the need for contraception or for surgery) which you can discuss with your doctor.  Medication is usually the first-line of treatment to preserve fertility as well as to avoid surgery unless necessary.  These options include

A. 1st line Medication

  • Contraceptive pills such as Progesterone OCP
  • Levonorgestrel-releasing IUCD (such as Mirena)
  • Depo-Provera
  • Tranexamic Acid
  • Non-Steroidal Anti-Inflammatory Drugs (NSAID) such as Mefenamic Acid

B. 2nd line Medication

  • Danazol (inhibits pituitary gonadotrophin)
  • GnRH Analogue
  • Ethamsylate

C. Surgical Options

  • Endometrial Ablation (to preserve fertility for future pregnancy)
  • Hysterectomy (definitive and most effective)

Discuss with your Gynae Doctor about your treatment options


Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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