Abnormal Vaginal Bleeding: Dysfunctional Uterine Bleeding

Irregular bleeding can occur in one or more periods of their lives in women who have regular periods. These are in the form of intermittent bleeding from time to time, and can be expressed from time to time as the duration of menstruation increases or the amount of menstruation increases. The reason for these bleeding; There may be pathologies such as myoma, polyp, infection, pregnancy complications, cancer or the onset of cancer, as well as factors such as stress, sadness, sudden weight loss, extreme sports. However, in the presence of abnormal bleeding, all organic causes should first be excluded by gynecological examination, ultrasonography, and if necessary, and then directed to other social or psychological origin.

Here we will describe abnormal vaginal bleeding that occurs without any underlying organic problems and proven that this group is called dysfunctional bleeding.


Normal Menstrual Cycle

The normal menstrual pattern occurs to the woman every 21-35 days, and this pattern may change depending on the day of ovulation. Although it does not always have to operate like a clock, it is a sign of order that it stays between 21-35 days. Menstrual period can vary from 2 to 8 days in women. In general, every woman has a unique order, and this will not change much.


Classification of Abnormal Vaginal Bleeding

Dysfunctional uterine bleeding is referred to by different definitions according to the clinical manifestation.

Amenorrhea: The woman does not have any menstrual periods within 3 or more cycles.

Hypomenorrhea: The amount of menstrual bleeding is very low.

Hypermenorrhea: Too much of menstrual bleeding.

Oligomenorrhea: The order of menstrual bleeding is less than once in 35 days.

Polimenore: The menstrual pattern is more common than once in 21 days.

Menorrhagia: Prolonged menstrual period according to the normal order of the woman.

Metroragy: Intermediate bleeding except menstrual bleeding.

Menometrorrhagia: Bleeding is excessive and at irregular intervals.


Ovulation bleeding: Slight bleeding that may be accompanied by occasional pain seen in the middle of the two.


Frequency of Abnormal Vaginal Bleeding

Dysfunctional uterine bleeding accounts for 10% of gynecological complaints. 90% of these bleeding is caused by no ovulation in the menstrual cycle and is called anovulatory bleeding. It is most common in women’s life during adolescence and premenopause. In women with obesity outside these periods, abnormal bleeding may occur during breastfeeding and polycystic ovarian syndrome, too, because ovulation does not often occur. As the egg cannot develop, the estrogen hormone continues to work and the intrauterine tissue continues to thicken because it cannot be covered with progesterone. After a while, the intrauterine tissue will break and bleeding will occur.

Although there is ovulation, there may be intermediate bleeding. There may be intermediate bleeding during ovulation, as well as early menstruation due to early ovulation, or late menstruation due to late ovulation.


Diagnosis in Abnormal Vaginal Bleeding

In the woman with abnormal vaginal bleeding, dysfunctional uterine bleeding is diagnosed when an organic problem cannot be detected after gynecological examination, ultrasonography, hormonal examinations, etc., if necessary.

Here in the differential diagnosis; fibroids, polyp, intrauterine tissue inflammation, ectopic pregnancy, threats of miscarriage and miscarriage, ovarian cysts, cancers or cancerous lesions, drug use, blood diseases and liver diseases should be ruled out.


Treatment of Abnormal Vaginal Bleeding

The treatment program is directly related to age. In women over 35, abortion may be required to stop bleeding and / or make a pathological diagnosis. This procedure will be required less frequently in women under 35 years of age.

In medical treatment, estrogen or progesterone preparations can be used individually or in combination in order to stop bleeding and then restore menstruation.