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202458482_final_case_presentation_abnormal_uterine_bleeding.doc

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Introduction
Abnormal uterine bleeding is a condition in which a woman bleeds from her
uterus at an unexpected time or in a way that is unusual for her. For example,
bleeding between periods, a period that is heavier longer-lasting than normal,
bleeding after sexual intercourse, clots or spots in the menstrual blood and any
bleeding after menopause may all be considered abnormal uterine bleeding.
The most common reason for irregular uterine bleeding is pregnancy.
Spotting or very light bleeding may occur with no real significance, but you should
always check with your doctor if you’re bleeding while pregnant. Another common
reason for abnormal menstrual bleeding is having too much or too little of certain
hormones. This often occurs during adolescence, when hormone levels fluctuate.
Intrauterine device (IUD) can cause abnormal bleeding by irritating the uterine
lining. The bleeding is usually accompanied by cramping. Also called Stein-
Leventhal syndrome, Polycystic Ovarian Syndrome occurs when you don’t ovulate
regularly. If your period comes with pain or foul-smelling greenish discharge you
may have an infection of a pelvic organ, such as your uterus, cervix or ovaries.
Bleeding would commonly follow sex or douching. These infections are often
caused by sexually transmitted diseases. Fibroid tumors are non-cancerous
tumors that grow in the uterine muscle. They usually affect women in their 30s or
40s. most common among black women, they are also fairly common among white
women, but extremely rare in Asian women. Other possible reasons for abnormal
menstrual bleeding include polyps, small growths that develop in the cervix or
uterus. Their causes are unclear, but are related to an excess of estrogen, which
may be result of an infection, hormone treatment or some types of ovarian tumors.
The most probable etiology of abnormal uterine bleeding relates to the
patient’s reproductive age, as does the likelihood of serious endometrial pathology.
The specific diagnostic approach depends on whether the patient is
premenopausal, perimenopausal or postmenopausal. In premopausal women with
normal findings on physical examination, the most likely diagnosis is dysfunctional
uterine bleeding (DUB) secondary to anovulation, and the diagnostic investigation
is targeted at identifying the etiology of anovulation.

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Abnormal uterine bleeding (AUB) in nonpregnant women is a common
problem. In fact, AUB accounted for almost 4 million outpatient visits (mostly to
physicians’ offices) in the United States in 1996. Indeed, this problem may prompt
more than 20% of all visits to OB/GYNs, and may account for more than one fourth
of all hysterectomies. AUB is rare in prepubertal females. Newborn girls
occasionally have a slight bloody vaginal discharge secondary to withdrawal of
placental estrogens. AUB is common in adolescents because of the 1- to 5- year
delay in development of regular ovulatory menstrual cycles after menarche. AUB
also tens to be more common during the fifth decade of life (the perimenopausal
years). In the worst case, AUB may be a sign of atypical endometrial hyperplasia,
which, if undiagnosed and untreated, can progress to uterine cancer-the most
common female genital cancer. In 1998, estimated 36,100 women were diagnosed
with uterine cancer, which led to approximately 6,300 deaths.
One popular form of treatment for abnormal uterine bleeding is birth control
pills, which contain hormones that can prevent the uterus lining from thickening. If
birth control pills are’nt stopping the bleeding, a doctor may prescribe an
intrauterine (IUD) device. An IUD is a plastic device that is inserted into a woman’s
uterus to prevent pregnancy. In rare cases, surgery may be needed to stop
abnormal bleeding. Two surgical procedures are recommended: hysterectomy and
endometrial ablation.
OBJECTIVES
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Introduction Abnormal uterine bleeding is a condition in which a woman bleeds from her uterus at an unexpected time or in a way that is unusual for her. For example, bleeding between periods, a period that is heavier longer-lasting than normal, bleeding after sexual intercourse, clots or spots in the menstrual blood and any bleeding after menopause may all be considered abnormal uterine bleeding. The most common reason for irregular uterine bleeding is pregnancy. Spotting or very light bleeding may occur with no real significance, but you should always check with your doctor if you’re bleeding while pregnant. Another common reason for abnormal menstrual bleeding is having too much or too little of certain hormones. This often occurs during adolescence, when hormone levels fluctuate. Intrauterine device (IUD) can cause abnormal bleeding by irritating the uterine lining. The bleeding is usually accompanied by cramping. Also called Stein-Leventhal syndrome, Polycystic Ovarian Syndrome occurs when you don’t ovulate regularly. If your period comes with pain or foul-smelling greenish discharge you may have an infection of a pelvic organ, such as your uterus, cervix or ovaries. Bleeding would commonly follow sex or douching. These infections are often caused by sexually transmitted diseases. Fibroid tumors are non-cancerous tumors that grow in the uterine muscle. They usually affect women in their 30s or 40s. most common among black women, they are also fairly common among w ...
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