Get exclusive member benefits & effect social change. Join Today
Dysfunctional uterine bleeding (DUB) is a condition that affects nearly every woman at some point in her life. Also called abnormal uterine bleeding (AUB), DUB is a condition that causes vaginal bleeding to occur outside of the regular menstrual cycle. According to the American Society for Reproductive Medicine, it is most common during puberty and menopause, but can occur any time that hormones are imbalanced. Certain hormonal conditions and medications may also trigger DUB.
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/or spotting. Spotting is bleeding that is lighter than a normal menstrual period. It often appears brown, pink, or light red.
The hormonal imbalances that cause DUB can also be side effects of medical conditions or of medications themselves.
Medical conditions that often cause dysfunctional uterine bleeding are:
Certain medications can also cause dysfunctional uterine bleeding, including:
The most common symptom of DUB is bleeding outside of your normal periods. It can also occur within your menstrual cycle. In this case, it might include:
Other common DUB symptoms are:
If you experience any of the following severe DUB symptoms, contact your doctor immediately:
To diagnose DUB, your doctor will ask questions about your medical history and the history of your cycle. These answers will help him or her determine your risks for certain reproductive disorders like PCOS and endometriosis. If you are taking any medication, including birth control, mention this to your doctor, as such drugs cause abnormal bleeding.
Your doctor may recommend an ultrasound to view your reproductive organs. This examination will reveal whether or not you have any abnormal growths such as polyps or fibroids. It can also help to rule out internal bleeding.
Blood tests are used to measure your hormone levels and your complete blood count. Your hormone levels can often give quick insight into the cause of your bleeding. If you’ve had heavy or prolonged bleeding, a complete blood count reveals whether your red blood cell count is too low. A low red blood cell count can indicate anemia.
If an abnormal growth is causing the bleeding, or your uterine lining is unusually thick, your doctor will take a sample of the uterine tissue for testing. If there are any abnormal cell changes in the lining, a biopsy will reveal it. Abnormal cells can indicate hormone imbalances or cancer, among other things.
There are many treatment options available for DUB. Sometimes, in cases of puberty especially, no action is taken, as the hormones usually correct themselves. The right treatment for you will depend on the underlying cause of the bleeding.
The most common and simplest treatment option for dysfunctional uterine bleeding is a combination of oral contraceptives. Combination oral contraceptives contain synthetic estrogen and progesterone. These both work to control and regulate the menstrual cycle. If you aren’t trying to conceive, your doctor may recommend taking these as a treatment option.
If the bleeding is heavy and combination oral contraceptives aren’t an option, intravenous estrogen can be administered until the bleeding subsides. This is normally followed by a course of oral progestin to balance the hormones.
If you’re trying to conceive and you don’t have heavy bleeding, your doctor may prescribe the ovulation-stimulating drug clomiphene, also called clomid. Stimulating ovulation can stop prolonged menstrual bleeding.
Heavy and prolonged bleeding accompanied by a thickened uterine lining can be treated with a procedure called dilation and curettage (D and C). This is an outpatient surgical procedure used to remove part of the uterine lining by scraping it away.
If your uterine cells are found to be abnormal, your doctor may order an additional biopsy after treatment. Depending on the results of the biopsy — if the cells are cancerous, for instance — a hysterectomy may be recommended. A hysterectomy is a complete removal of the uterus and is usually a last resort.
Generally, DUB is a temporary condition. Once the sex hormones are regulated, abnormal bleeding usually subsides.
Anemia is one of the main complications of heavy bleeding. If you develop anemia due to significant blood loss, your physician may treat it with minerals and vitamin supplements. In rare cases where the bleeding has caused significant blood loss, you may need a blood transfusion.
Written by: April Kahn
Medically reviewed on: Feb 08, 2016: Mark Laflamme, MD
Enter your symptoms in our Symptom Checker to find out possible causes of your symptoms. Go.
Enter any list of prescription drugs and see how they interact with each other and with other substances. Go.
Enter its color and shape information, and this tool helps you identify it. Go.
Find information on drug interactions, side effects, and more. Go.