Dysfunctional uterine bleeding, or DUB, is defined as abnormal bleeding from the uterus, often due to hormone changes. While many women bleed due to miscarriage, fibroids, tumors, or blood clotting issues, such bleeding is not the same as DUB. Dysfunctional uterine bleeding is often related to the menstrual cycle since so many hormonal changes are associated with it. The main symptoms include heavy bleeding that requires a change of pad every hour, a period that lasts longer than a week, or a period that either comes more than every three weeks or less often than every five weeks. Most doctors are able to diagnose this issue only after other possibilities are ruled out, though blood, pelvic, and urine tests may help narrow down the cause of the bleeding.
While most women have an occasional abnormality during their menstrual cycle, those affected by dysfunctional uterine bleeding usually notice frequent changes during their menstrual period. Women who typically need to change their pad or tampon every hour are likely bleeding too much, and should see a doctor for this issue. The same goes for women who get their period more often than once in 21 days, and those who go more than 35 days without a period for no apparent reason. Of course, a period that lasts longer than seven days can also signal excessive bleeding, and may be cause for concern.
This problem may even occur in women who do not ovulate, as women can still bleed during anovulatory cycles. Bleeding without ovulation having occurred is most commonly seen in females who just began menstruating, as well as those approaching menopause. This is because the hormonal levels still change, even in the absence of ovulation, as the progesterone level does not increase to help balance the continually high level of estrogen during this time.
Dysfunctional uterine bleeding is often diagnosed through a range of tests to ensure that it is not due to some other medical issue. A pelvic exam is typically required, followed by a urine or blood test, depending on what the doctor thinks it may be. A biopsy, or small tissue sample from the uterus, may need to be taken, as well. If these tests reveal no obvious cause of the bleeding, dysfunctional uterine bleeding will usually be diagnosed.
Fortunately, there are various ways to treat this issue. For example, high doses of estrogen via a pill can be used to stop excessive bleeding, while a pill with either progestin only or both estrogen and progestin may be taken regularly to relieve cramping and excess bleeding. If these or similar pills do not stop the problem, surgery may be required. This may include endometrial ablation, which is meant to get rid of the current uterine lining so that it can scar and eventually heal.