What is DUB?
DUB or Dysfunctional uterine bleeding is any bleeding from the vagina that varies from a woman’s normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle’s hormonal signals get thrown off. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer cycles. DUB or Dysfunctional Uterine Bleeding is also called Anovulatory bleeding or Abnormal uterine bleeding (AUB). DUB is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Bleeding may occur often or randomly.
The Regular Cycle..
Every woman’s menstrual cycle is different.
On an average,
- a woman’s period (menstrual flow) occurs every 28 days, although cycles may vary between 24 and 34 days.
- Menstruation flow normally last about 4 to 7 days.
- Young girls may get their periods anywhere from 21 to 45 days or more apart.
- Women in their 40s may start to have their period less often or have the interval between their periods decrease.
What causes DUB?
For most women, female hormone levels change every month. The hormones estrogen and progesterone are released as part of the process of ovulation. When a woman ovulates, an egg is released.
When the ovaries do not release an egg DUB can occur. Changes in hormone levels cause the period to be later or earlier. It may sometimes be heavier than normal.
The main cause of dysfunctional uterine bleeding is an imbalance in the sex hormones.
Girls experiencing puberty and women entering menopause can have imbalanced hormone levels for months or even years. This causes sporadic bleeding, heavy bleeding, and spotting. Spotting is bleeding that’s lighter than a normal menstrual period. It often appears brown, pink, or light red.
Women who are overweight also may be more likely to have DUB.
The hormonal imbalances that cause DUB can also result from certain medical conditions like..
- Thickening of the uterine wall or lining
- Uterine fibroids Uterine fibroids are small growths that occur within the uterus, uterine lining, or uterine muscle. Like polyps, the causes of uterine fibroids are unknown. But estrogen seems to play a role in their growth.
- Uterine polyps These small growths occur within the uterus. Although their cause is unknown, polyp growth is heavily influenced by the hormone estrogen. Small blood vessels in the polyps can cause DUB, including spotting between periods.
- Endometriosis. This condition results when the uterine lining grows outside of the uterus, such as on the ovaries. Endometriosis can cause heavy bleeding during regular periods.
- Polycystic ovary syndrome This is an endocrine disorder that causes a woman to produce an imbalanced amount of sex hormones. This may lead to an imbalance in estrogen and progesterone, making the menstrual cycle irregular.
- Cancers of ovaries, uterus, cervix, or vagina
- Bleeding disorders or problems with blood clotting
- Hormonal birth control, such as birth control pills or intrauterine devices (IUD)
- Infection of the uterus or cervix
- Severe weight loss
- Excessive weight gain or loss (more than 10 pounds or 4.5 kilograms)
Know the Symptoms of DUB..
The most common symptom of DUB is bleeding outside of the normal periods. It can also occur within your menstrual cycle.
Suspicious bleeding patterns include:
- heavy menstrual bleeding
- bleeding that contains many clots or large clots
- bleeding that lasts more than 7 days
- bleeding that occurs less than 21 days from the last cycle
- bleeding that occurs later than 35 days from the last cycle
- bleeding between periods
Other common symptoms that can occur with DUB are:
- pelvic pain or pressure
- Excessive growth of body hair in a male pattern (hirsutism)
- Hot flashes
- Mood swings
- Tenderness and dryness of the vagina
When there is any of the following severe DUB symptoms, requires doctor consultation immediately:
- low blood pressure
- increased heart rate
- pale skin
- passing large clots
- soaking a pad every hour
- bleeding with a positive pregnancy test
How to Diagnose DUB?
To diagnose DUB, doctor will ask questions about your medical history and the history of your cycle. These answers will help them determine your risks for certain reproductive disorders, like PCOS and endometriosis.
If you’re taking any medication, including birth control, mention this to your doctor, as such drugs can cause abnormal bleeding.
Your doctor may recommend following tests to rule out the causes:
- Complete blood count (CBC)
- Blood clotting profile
- Liver function tests (LFT)
- Fasting blood glucose
- Hormone tests, for FSH, LH, male hormone (androgen) levels, prolactin, and progesterone
- Thyroid function tests
Your doctor may also recommend the following:
- Pregnancy test
- PAP Smear Test
- Culture to look for infection
- Biopsy to check for precancer, cancer, or to help decide on hormone treatment
- Hysteroscopy, to look into the uterus through the vagina
- Ultrasound to look for problems in the uterus or pelvis
Treatment Of DUB..
There are many treatment options available for DUB.
The most common and simple treatment option for DUB (dysfunctional uterine bleeding) is combination oral contraceptives.
- Combination oral contraceptives contain synthetic estrogen and progesterone. These both work to control and regulate the menstrual cycle.
- Contraceptive methods including some progestin IUDs and the progestin implant can also be used as hormonal treatment.
If the bleeding is suddenly very heavy and lower-dose medications aren’t working, intravenous estrogen can be administered until the bleeding subsides. This may be followed by a course of oral progestin to balance the hormones.
When someone is trying to conceive and don’t have heavy bleeding, doctor may prescribe the ovulation-stimulating drug like clomiphene. Stimulating ovulation can stop prolonged menstrual bleeding by resetting your menstrual cycle.
But in cases of puberty especially, no action is taken, as the hormones usually correct themselves.
Women with severe symptoms that don’t improve or if the cause of the bleeding is a polyp or fibroid or who have a cancerous or precancerous diagnosis may require other procedures such as:
- Surgical procedure to destroy or remove the lining of the uterus
- Hysterectomy to remove the uterus
What In Homoeopathy?
There is no specific medicine for DUB in Homoeopathy.. When you are diagnosed with DUB or may be suspected, your will doctor prescribe medicine depends upon your Totality of symptoms which will be your work for choice.
But ,there are few medicines which are more commonly used than others:
- Ambra Grisea
- Calcarea carb
- Cinchona off
- Crotalus H
- Nux Vom
- Nitric Acid
- Secale Cor
- Trillium P
But always consult your doctor before taking any of this medicine.
Is There Any Complications Of DUB?
Complications that may occur:
- Severe anemia is the one of the main complication due to a lot of blood loss over time
- Infertility (inability to get pregnant)
- Increased risk for endometrial cancer
The Bottom Line:
Dysfunctional uterine bleeding (DUB) is very common and treatable. It is rarely cause for concern. However, if you experience any symptoms of irregular bleeding, or if you feel concerned about your symptoms, talk with your doctor.
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