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DYSFUNCTIONAL UTERINE BLEEDING

(HEAVY EPISODE OF VAGINAL BLEEDING)
Dysfunctional Uterine Bleeding

WHAT YOU NEED TO KNOW:

What is dysfunctional uterine bleeding? Dysfunctional uterine bleeding (DUB) is abnormal uterine bleeding that is caused by a problem with your hormones. You may have bleeding from your uterus at times other than your normal monthly period. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual.

What causes DUB? DUB may be caused by too much or too little estrogen. You may have abnormal bleeding if an ovary does not release an egg during ovulation. Medical conditions such as polycystic ovary syndrome may increase your risk for DUB.

What are the signs and symptoms of DUB?

  • Bleeding or spotting between periods

  • Bleeding that starts 12 months or longer after you have been through menopause

  • The amount of bleeding during your period is heavier or lighter than usual

  • The number of days that you bleed during your regular period is longer than usual, or more than 7 days

  • The number of days that you bleed is shorter than usual, or less than 2 days

  • The time between your monthly periods is shorter or longer than usual

How is DUB diagnosed?

  • Blood tests may be done to find the cause of your DUB and problems caused by DUB, such as anemia.

  • A pelvic exam may be done to find the source of your bleeding.

  • A hysteroscopy is a procedure to look at your endometrium. The endometrium is the lining inside of your uterus. Your healthcare provider will insert a small tube with a camera at the end into your uterus.

  • A biopsy is a procedure to remove a small piece of tissue from the endometrium. The tissue is sent to a lab for tests.

  • An ultrasound uses sound waves to show pictures of your uterus, ovaries, tubes, and vagina on a monitor.

  • A pap smear may be needed. Your healthcare provider takes a sample of tissue from your cervix and sends it to a lab for tests.

How is DUB treated?

  • Medicines:
    • Hormones help decrease bleeding by making your monthly periods more regular. Sometimes this medicine may be given as birth control pills.

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

    • Iron supplements may be given if your blood iron level decreases because of heavy bleeding. Iron may make you constipated. Ask your healthcare provider for ways to prevent or treat constipation. Iron may also make your bowel movements turn dark or black.

  • Surgery and procedures may be needed if medicines do not work or cannot be used. You may need procedures, such as endometrial ablation or dilation and curettage, to control your bleeding. You may need an abdominal or vaginal hysterectomy. A hysterectomy is surgery to remove your uterus.

How do I care for myself at home?

  • Apply heat on your lower abdomen for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain and muscle spasms.

  • Include foods high in iron if needed. Examples of foods high in iron are leafy green vegetables, beef, pork, liver, eggs, and whole-grain breads and cereals.

  • Keep a diary of your menstrual cycles. Keep track of the number of tampons or pads you use each day.

  • Talk to your healthcare provider before you start a weight loss program. You may need to wait until the abnormal bleeding has stopped before you try to lose weight. The amount of iron in your blood should be normal before you lose weight.

When should I contact my healthcare provider?

  • You need to change your sanitary pad or tampon more than once an hour.

  • Your medicine causes nausea, vomiting, or diarrhea.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You continue to bleed heavily, or you feel faint.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.