Menstruation and Menstrual Disorders - Irregular Menstruation (Abnormal Uterine Bleeding)

Question 1

What is Abnormal Uterine Bleeding?

Answer 1

Irregularities in the menstrual cycle - any change in frequency, duration, regularity or volume.

Question 2

What do irregular menstrual periods indicate?

Answer 2

Anovulation or irregular ovulation.

Question 3

Aetiology of Abnormal Uterine Bleeding.

Answer 3

Disruption of the normal hormonal levels in the menstrual cycle or ovarian pathology.

Question 4

Epidemiology of Abnormal Uterine Bleeding.

Answer 4

Common following menarche as periods can take 2-3 years to regulate.

Question 5

Differential Diagnoses of Abnormal Uterine Bleeding (9).

Answer 5

1. Extremes of Reproductive Age.
2. Polycystic Ovarian Syndrome.
3. Physiological Stress.
4. Medications.
5. Hormonal Imbalances.
6. STIs.
7. Endometrial Hyperplasia & Cancer, Cervical Cancer.
8. Fibroids.
9. Pregnancy.

Question 6

Management of Idiopathic Abnormal Uterine Bleeding (4).

Answer 6

1. Contraception (COCP) if investigations rule out pathology.
2. IUS - reduces bleeding.
3. Progestogens - induce amenorrhoea (but not to be relied on long term.
4. Norethisterone - take on day 5-26 to prevent bleeding.