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Dysfunctional Uterine Bleeding

In most cases, heavy vaginal bleeding is related to abnormal hormone levels that upset the menstrual cycle. However, it can also be the result of disease, infection or pregnancy complications.

What is dysfunctional uterine bleeding?

The term "dysfunctional uterine bleeding" is used to describe heavy vaginal bleeding that isn't caused by a serious medical problem. In most cases, heavy often irregular bleeding is related to abnormal hormone levels that throw off the menstrual cycle.

Dysfunctional uterine bleeding is not used to describe vaginal bleeding caused by medical conditions such as miscarriage, uterine growths such as fibroids, cancer of the cervix or uterus or blood diseases. If you are having heavy vaginal bleeding, your health professional must rule out these other conditions before diagnosing you with dysfunctional uterine bleeding.

What causes dysfunctional uterine bleeding?

There are two types of dysfunctional uterine bleeding
  • Anovulatory ("not ovulating"), caused by a low level of the hormone progesterone. Progesterone is necessary for the ovary to regularly release an egg (ovulation), as well as for regulating menstrual bleeding. Low progesterone causes irregular and heavy menstrual bleeding. This type of dysfunctional uterine bleeding is common before age 20 and after age 40 (perimenopause). During these times of transition into and out of the fertile years, it's normal for progesterone levels to be variable.

  • Ovulatory. As many as 10% of ovulating women have dysfunctional uterine bleeding despite having normal levels of progesterone and other hormones. In these cases, no hormonal or other cause can be found. Experts do not fully understand this type of dysfunctional uterine bleeding and its causes.
What are symptoms of dysfunctional uterine bleeding?

You may have dysfunctional uterine bleeding if you have one or more of the following symptoms
  • Menstrual bleeding that occurs more often than every 21 days or farther apart than 35 days (a normal menstrual cycle is 24 to 35 days long)

  • Menstrual bleeding that lasts longer than 7 days (normally 4 to 6 days)

  • Blood loss of more than 80 mL each menstrual cycle (normally about 30 mL). If you are passing large clots or soaking a large pad per hour for 8 hours, your bleeding is considered heavy.
How is dysfunctional uterine bleeding diagnosed?

Dysfunctional uterine bleeding is a "diagnosis of exclusion." This means that your health professional has ruled out other medical causes of vaginal bleeding such as miscarriage, pregnancy complications, or disease, and common and less serious causes such as adenomyosis and uterine fibroids. Your health professional may conclude that natural hormonal or other processes are causing your symptoms.

If you have had heavy or frequent vaginal bleeding for three or more menstrual cycles, or your symptoms are affecting your daily functioning, see your health professional. By reviewing the frequency, duration, and amount of bleeding you have been having, combined with a pelvic examination, urine test, blood tests, and possibly an ultrasound, your health professional will be able to check for a number of causes of your symptoms. A biopsy of endometrial tissue may also be helpful.

How is dysfunctional uterine bleeding treated?

A number of treatment options are available for dysfunctional uterine bleeding. Some are meant to return the menstrual cycle to normal; others are used to reduce bleeding or to eliminate menstruation. Each of these options works effectively for some women but not others. Treatments include:
  • Progesterone has been shown to help prevent overgrowth of The Endometrium, which prevents dysfunctional uterine bleeding.(Heavy Bleeding is often the product of irregular breakdown of the endometrium In Teens and women who aren’t ovulating regularly, progesterone promotes ovulation, restores a predictable cyclic monthly menstrual period.

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can curb heavy uterine bleeding.

  • Use of the levonorgestrel IUD, which releases a progesterone-like, synthetic hormone into the uterus. This reduces bleeding while preventing pregnancy. It has many side effects and before committing to this understand what you can be up against.

  • Hormone treatment. A short course of high-dose estrogen therapy is often used to stop dangerously heavy bleeding. For ongoing treatment, a daily birth control pill (progestin and estrogen) or progestin pill regulates the menstrual cycle, reducing bleeding and cramping.

  • Rarely used medications that stop estrogen production and menstruation, such as gonadotropin-releasing hormones or danazol. These medications cause severe side effects but are used in special cases.

  • Surgery, such as dilation and curettage (D&C) for short-term relief of severe bleeding or endometrial ablation for longer-term relief of bleeding.

  • In cases of severe uterine bleeding, blood transfusion may be used to quickly restore needed blood volume before a longer-term treatment is used.

  • In uncontrollable cases of uterine bleeding, the uterus may be removed (hysterectomy).
Treatment Options Surgery

Surgery is generally reserved for treating dysfunctional uterine bleeding that can't be controlled with medication.

Surgery Choices

The following procedures are used to treat dysfunctional uterine bleeding.

Hysteroscopy can be used to diagnose and treat dysfunctional uterine bleeding at the same time. When areas of bleeding are located, biopsies can be taken and then the areas of bleeding can be treated with either a laser beam or electric current (electrocautery).

Endometrial ablation is a minimally invasive alternative to hysterectomy when other medical treatments fail or when you or your doctor have reasons for not using other treatments. Endometrial ablation scars the uterine lining, so it is not a treatment option if you are planning to become pregnant.

Hysterectomy, the removal of the uterus, is done when a sample of the uterine lining (endometrial biopsy) shows abnormal cell changes or cancer, when uterine bleeding is uncontrollable, or when the cause of chronic bleeding cannot be found and treated. Some women prefer hysterectomy to medications with troublesome side effects. However, a hysterectomy is a major surgery with risks of complications, which requires a prolonged recovery and long-term estrogen replacement therapy after surgery.

Dilation and curettage (D&C) is sometimes used to control sudden, heavy vaginal bleeding. It is the quickest way to stop bleeding in the uterus.

What To Think About

Hysteroscopy is typically done to rule out serious uterine conditions.

Before long-term treatment with medications or surgical treatment for dysfunctional uterine bleeding. When uterine bleeding has continued despite conservative treatment.

Frequently Asked Questions-Dysfunctional Uterine Bleeding

Questions about Dysfunctional Uterine Bleeding

What is dysfunctional uterine bleeding?

What causes dysfunctional uterine bleeding?

What are symptoms of dysfunctional uterine bleeding?

What increases my risk of dysfunctional uterine bleeding?

Questions about diagnosis and treatment of Dysfunctional Uterine Bleeding

How is dysfunctional uterine bleeding diagnosed?

What treatment options do I have for dysfunctional uterine bleeding?

What kinds of medication can I take to reduce dysfunctional uterine bleeding?

What is the levonorgestrel IUD does it help dysfunctional uterine bleeding?

What kinds of surgery are used to treat dysfunctional uterine bleeding?

What is endometrial ablation?

What is a hysteroscopy?

Should I use hormone therapy to treat dysfunctional uterine bleeding?

Natural Alternatives to Dysfunctional Uterine Bleeding

Bioidentical progesterone cream (Progensa 20)

Bioidentical progesterone cream increases progesterone levels. You need adequate and sustain levels of progesterone to induce ovulation. Dysfunctional uterine bleeding is due to too little progesterone being produced by the body.

Herbal Formula (ProSoothe)

ProSoothe is an all natural herbal formula that significantly improves uterine fibroids and pelvic pain/cramps, irritability, tension, mood swings, acne, headaches, breast pain, bloating and weight gain.

Also found in this synergistic herbal formula is dandelion and vitex,(chaste tree) that helps the body remove exogenous,(external excess estrogen)from hormone therapy or contaminated food,(xenosteroids).

Milk Thistle (Silymarin)

Beyond the treatment of liver disorders, everyday care of the liver lays a cornerstone for total body health. Naturopaths and others who look beneath the symptoms of an illness to its underlying cause, often discover that the liver has had a role to play. This is true across a vast range of different ailments from headaches to PMS.

More Information-Dysfunctional Bleeding

Dysfunctional Uterine Bleeding-F.A.Q.

Endometrial Ablation

Recommended Herbs

Dysfunctional Uterine Bleeding-Condition Treatments
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