Is this topic for you?
This topic is for women who
want to learn about or have been diagnosed with dysfunctional uterine bleeding
(DUB). It is related to abnormal changes in
hormone levels. If you don't know what kind of
bleeding you have, see the topic
Abnormal Vaginal Bleeding.
What is dysfunctional uterine bleeding?
Dysfunctional uterine bleeding is irregular bleeding from the
uterus. For example, you may get your
period more often than every 21 days or farther apart
than 35 days. Your period may last longer than 7 days. It is not serious, but
it can be annoying and can disrupt your life.
In most cases, this
problem is related to abnormal changes in hormone levels. It is not caused by other medical conditions, such as
fibroids, cancer, or blood clotting problems. Your
doctor will rule out these and other causes of vaginal bleeding to confirm that
you have dysfunctional uterine bleeding.
What causes dysfunctional uterine bleeding?
Dysfunctional uterine bleeding is usually caused by abnormal changes in hormone
levels. In some cases the cause of the bleeding isn't known.
Normally one of your
ovaries releases an egg during your menstrual cycle.
This is called
ovulation. Dysfunctional uterine bleeding is often
triggered when women don't ovulate. This causes abnormal changes in hormone levels and
in some cases can lead to unexpected vaginal bleeding.
also get this condition even though they ovulate, although this is less common.
Experts don't fully understand this type of vaginal bleeding. It may be caused
by changes in certain body chemicals.
What are the symptoms?
You may have dysfunctional
uterine bleeding if you have one or more of the following symptoms:
- You get your period more often than every 21
days or farther apart than 35 days. A normal adult menstrual cycle is 21 to 35
days long. A normal teen cycle is 21 to 45 days.
- Your period lasts
longer than 7 days (normally 4 to 6 days).
- Your bleeding is
heavier than normal. If you are passing blood clots
and soaking through your usual pads or tampons each hour for 2 or more hours,
your bleeding is considered severe and you should call your doctor.
Talk to your doctor if you have had irregular vaginal
bleeding for three or more menstrual cycles or if your symptoms are affecting
your daily life.
How is dysfunctional uterine bleeding diagnosed?
Your doctor must first rule out all other causes of vaginal bleeding
before diagnosing dysfunctional uterine bleeding. These causes include
miscarriage and problems with pregnancy. Vaginal bleeding may also be caused by
common conditions, such as uterine fibroids.
Your doctor will ask
how often, how long, and how much you have been bleeding. You may also have a
pelvic exam, urine test, blood tests, and possibly an
ultrasound. These tests will help your doctor check for other causes of your
symptoms. He or she may also take a tiny sample (biopsy) of
tissue from your uterus for testing.
You have dysfunctional
uterine bleeding if, after testing, your doctor finds no other diseases or
conditions that are causing your symptoms.
How is it treated?
There are many things you can
do to treat dysfunctional uterine bleeding. Some are meant to return the
menstrual cycle to normal. Others are used to reduce bleeding or to stop
monthly periods. Each treatment works for some women but not others. Treatments
- Hormones, such as a progestin pill or daily
birth control pill (progestin and estrogen). These hormones help control the
menstrual cycle and reduce bleeding and cramping.
- A short course of high-dose
estrogen. Estrogen is a hormone that is often used to
stop dangerously heavy bleeding.
- Use of the levonorgestrel
IUD, which releases a progesterone-like hormone into
the uterus. This reduces bleeding while preventing pregnancy.
- Rarely used medicines that stop estrogen production and
menstruation, such as gonadotropin-releasing hormones. These drugs can cause
severe side effects but are used in special cases.
- Surgery, such
endometrial ablation or
hysterectomy, when other treatments do not work.
If you also have menstrual pain or heavy bleeding, you
can take regular doses of a nonsteroidal anti-inflammatory drug (NSAID), such
In some cases, doctors use
watchful waiting, or a wait-and-see approach. It may
be okay for a teen or for a woman nearing
menopause. Some teens have times of irregular vaginal
bleeding. This usually gets better over time as hormone levels even out. Women
in menopause can expect their periods to stop. They may choose to wait and see
if this happens before they try other treatments.
Frequently Asked Questions