Dysfunctional Uterine Bleeding (DUB)

📚INTRODUCTION

DUB is a common gynecological problem characterized by abnormal uterine bleeding without any organic, systemic, or pregnancy-related cause.

It is most common in adolescents and perimenopausal women due to hormonal imbalance.

♦️DEFINITION

DUB is defined as abnormal uterine bleeding occurring in the absence of identifiable pelvic pathology, pregnancy, or systemic disease

⚡RISK FACTORS

• Hormonal imbalance (estrogen & progesterone)

• Adolescence (immature HPO axis)

• Perimenopause

• Stress

• Obesity

• Thyroid disorders

• Polycystic ovarian syndrome (PCOS)

• Diabetes mellitus

• Use of hormonal drugs

  
  

🎢TYPES

• Ovulatory DUB – Regular cycles but heavy bleeding

• Anovulatory DUB – Irregular, unpredictable bleeding (most common)

  
  

⭕CLINICAL MANIFESTATIONS

• Irregular menstrual cycles

• Heavy or prolonged bleeding (menorrhagia)

• Bleeding between cycles

• Passage of clots

• Fatigue and weakness

• Signs of anemia (pallor, dizziness)

  
  

🔷DIAGNOSIS

• History & physical examination

• Menstrual history (cycle, duration, amount)

• Pregnancy test (to exclude pregnancy)

• Blood tests: Hb, thyroid function, hormones

• Ultrasound (USG)

• Endometrial biopsy (if needed, especially >35 years)

• Pap smear

  
  

👨🏻‍⚕️MANAGEMENT

1. Medical Management

• NSAIDs → reduce bleeding

• Tranexamic acid → antifibrinolytic

• Hormonal therapy:

• Oral contraceptive pills (OCPs)

• Progesterone therapy

• Estrogen therapy (acute cases)

• Iron supplements → treat anemia

2. Surgical Management

• Dilatation and curettage (D&C)

• Endometrial ablation

• Hysterectomy (severe, not responding cases)

  
  

🏥NURSING MANAGEMENT

Assessment

• Monitor bleeding (pad count)

• Check vital signs

• Assess for anemia

Nursing Interventions

• Maintain bed rest in severe bleeding

• Monitor Hb level

• Administer prescribed drugs (OCPs, iron)

• Maintain fluid balance

• Prepare patient for procedures (D&C)

Health Education

• Maintain menstrual hygiene

• Balanced diet (iron-rich foods)

• Avoid stress

• Importance of follow-up

• Educate about medication compliance

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🚀Here’s a short “exam trick” version for Dysfunctional Uterine Bleeding (DUB) — super quick points you can remember :

Introduction: Common abnormal uterine bleeding without disease

Definition: Bleeding without organic, systemic, or pregnancy cause

Risk factors: Hormonal imbalance, stress, obesity, PCOS

Types: Ovulatory (regular) / Anovulatory (irregular)

Clinical manifestations: Irregular, heavy bleeding with anemia

Diagnosis: History, USG, blood tests, biopsy

Management: Hormones, NSAIDs, tranexamic acid, iron

Surgical: D&C, ablation, hysterectomy

Nursing management: Monitor bleeding, vitals, give meds, educate patient

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🚀Here’s a set of 07 MCQs on Dysfunctional Uterine Bleeding (DUB) for practice:

1.DUB is defined as:

a) Bleeding due to pregnancy

b) Bleeding due to tumor

c) Bleeding without organic cause ✅

d) Bleeding due to infection

2. Most common cause of DUB is:

a) Infection

b) Hormonal imbalance ✅

c) Trauma

d) Cancer

3. Most common type of DUB is:

a) Ovulatory

b) Anovulatory ✅

c) Infective

d) Traumatic

4. Common age group affected by DUB:

a) Childhood

b) Adolescence & perimenopause ✅

c) Only elderly

d) Only pregnancy

5. Investigation to rule out pregnancy:

a) Hb test

b) Ultrasound

c) Pregnancy test ✅

d) Biopsy

6. Drug used to reduce bleeding in DUB:

a) Antibiotics

b) Antifungals

c) Tranexamic acid ✅

d) Antivirals

7. Severe DUB may lead to:

a) Hypertension

b) Anemia ✅

c) Diabetes

d) Asthma