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Dysfunctional Uterine Bleeding

Dysfunctional uterine bleeding is an older diagnosis for abnormal bleeding attributed to disordered ovulation after other important causes have been excluded.

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Key takeaways

  • Current practice classifies abnormal uterine bleeding by structural and non-structural causes instead of using a broad exclusion label.
  • Pregnancy testing is an early priority whenever pregnancy is possible, regardless of whether bleeding resembles a period.
  • Treatment depends on blood loss, anaemia, age, clot risk, contraception needs and plans for pregnancy.

The listings below do not establish the cause of bleeding or suit every person; clinical evaluation should guide treatment.

What should be excluded

History covers cycle pattern, medicines and associated pelvic symptoms. Blood count, pregnancy and thyroid testing, pelvic imaging or endometrial assessment may be indicated according to age and risk. Fibroids, polyps, bleeding disorders and endometrial disease require cause-specific care.

Controlling bleeding safely

Tranexamic acid and hormonal options have different roles in reducing flow or regulating cycles. Oestrogen-containing treatment is unsuitable with some clot and cardiovascular risks. Repeated irregular cycles may need protection of the uterine lining even when immediate pregnancy is not desired.

When to seek urgent care

Seek urgent care for soaking through pads repeatedly, fainting, marked weakness or breathlessness, severe one-sided pelvic pain, fever with pelvic pain, or pain and bleeding when pregnancy is possible.