Abstract:In the UK, 20% of all women, and 30% in the USA, have a hysterectomy before the age of 60; menorrhagia is the main presenting problem in at least 50-70%. In approximately 50% of cases, no organic pathology is determined, and dysfunctional uterine bleeding is diagnosed. Diagnosis and management of bleeding disorders may possibly reduce the need for surgical intervention, leading to a positive impact on women and the health service.
“…6 Abnormal uterine bleeding has various anatomic and physiologic causes (Table 1). Bleeding attributable to systemic conditions, pregnancy, and medications can most often be treated by managing the underlying cause.…”
Section: Management Of Aubmentioning
confidence: 99%
“…2011;86(3):229-240 AUB = abnormal uterine bleeding; E2 = estradiol; EA = endometrial ablation; EC = endometrial cancer; ER = estrogen receptor; FDA = Food and Drug Administration; GnRH = gonadotropin-releasing hormone; IUD = intrauterine device; LNG = levonorgestrel; NSAID = nonsteroidal anti-inflammatory drug; PR = progesterone receptor; SHBG = sex hormone-binding globulin gynecologic issues and conditions are prevalent in reproductive-age women. In the general population, more than 30% of reproductive-age women fulfill criteria for the diagnosis of menorrhagia, 6 25% have symptomatic fibroids, 7 and nearly 67% have an underlying uterine disorder with potential to cause abnormal uterine bleeding (AUB). 8 Among premenopausal women with breast cancer, management of menstrual disorders, contraception, vasomotor symptoms, and fertility presents a challenge.…”
“…6 Abnormal uterine bleeding has various anatomic and physiologic causes (Table 1). Bleeding attributable to systemic conditions, pregnancy, and medications can most often be treated by managing the underlying cause.…”
Section: Management Of Aubmentioning
confidence: 99%
“…2011;86(3):229-240 AUB = abnormal uterine bleeding; E2 = estradiol; EA = endometrial ablation; EC = endometrial cancer; ER = estrogen receptor; FDA = Food and Drug Administration; GnRH = gonadotropin-releasing hormone; IUD = intrauterine device; LNG = levonorgestrel; NSAID = nonsteroidal anti-inflammatory drug; PR = progesterone receptor; SHBG = sex hormone-binding globulin gynecologic issues and conditions are prevalent in reproductive-age women. In the general population, more than 30% of reproductive-age women fulfill criteria for the diagnosis of menorrhagia, 6 25% have symptomatic fibroids, 7 and nearly 67% have an underlying uterine disorder with potential to cause abnormal uterine bleeding (AUB). 8 Among premenopausal women with breast cancer, management of menstrual disorders, contraception, vasomotor symptoms, and fertility presents a challenge.…”
“…8 While in nearly half of all cases no organic pathology is found, a number of risk factors may contribute to the development of HMB. 8 In present study 69% patients had heavy menstrual bleeding with no identifiable cause. There were many treatment options including hemostatic drugs, hormones, endometrial ablation, LNG-IUS and the definitive treatment was hysterectomy.…”
Background: Heavy menstrual bleeding (HMB) is defined as prolonged (>7 days) or excessive menstrual blood loss greater than or equal to 80 ml per menstrual cycle. The objective of the study was to assess the efficacy, acceptability and side effects of LUS IUS in women with heavy menstrual bleeding.Methods: 42 women with heavy menstrual bleeding with or without associated dysmenorrhoea or chronic pelvic pain and had no contraindication to IUS insertion were included in the study. Patients having active genital tract infection, suspicion of pregnancy, uterine fibroids >2.5 cm in size or sub mucosal distorting the uterine cavity, uterine size >12 weeks, atypical endometrial hyperplasia or malignancy, abnormal cervical cytology, coagulopathy or liver disease were excluded from the study. Preliminary endometrial biopsy was done to rule out malignancy and LNG IUS was inserted under anaesthesia. Women were followed for 3,6,12 and 24 months post insertion.Results: In first 3 months, 20% patients achieved normal menstrual cycle, and at 6 months 44.44% had scanty menstrual flow and after 1 year of use 81.5% achieved amenorrhoea. In initial 3 months 37.5% patients had irregular heavy bleeding, which reduced to 13.89% at 6 months and 0% at 1 year follow up. Irregular spotting was second most complaint in 32.5% patients in initial 3 months that persisted in 7.4% patients at 1year follow up. In 5.0% patients, there was spontaneous expulsion of the device in first 3 menstrual cycles. After 3 months of use 57.5% patients were satisfied with the device and at the end of 1 year 92.5% were satisfied.Conclusions: LNG IUS is highly effective in controlling blood loss, well tolerated and better alternative for hysterectomy with higher user satisfaction in all age group of women.
“…2,3 Abnormal uterine bleeding has been shown to adversely affect mood, energy/vitality, work productivity, social interactions, family life and sexual functioning. 4,5 The effect abnormal uterine bleeding has on a women's Health Related Quality of Life (HRQL) derives from both the efforts associated with managing menstrual bleeding and the consequences of excessive blood loss, such as fatigue and iron deficiency anaemia.…”
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