What is Dysfunctional Uterine Bleeding?
Dysfunctional uterine bleeding is the abnormal bleeding of the uterine lining. This condition does not have any pathological causes such as fibroids and miscarriages and is simply due to hormonal imbalances. Dysfunctional uterine bleeding occurs when hormone-controlled signals which regulate uterine thickening during the menstrual cycle are thrown off. It leads to prolonged or shorter periods, mid-cycle bleeding and spotting during ovulation.
There are two types of dysfunctional uterine bleeding: ovulatory and anovulatory. Ovulatory dysfunctional bleeding occurs when a woman is ovulating. It is characterised by abnormal bleeding of the uterine lining due to low estrogen levels. 10% of women who suffer from dysfunctional uterine bleeding suffer from the ovulatory kind. On the other hand, 90% of women who suffer from dysfunctional uterine bleeding suffer from the anovulatory kind. This kind of uterine bleeding occurs when ovulation is not occurring. It affects women in their early stages of puberty and just before menopause. In this phenomenon, mature eggs are not released yet estrogen is continuously produced leading to uterine thickening.
What Causes Dysfunctional Uterine Bleeding?
- Failure of the ovaries to produce* a mature egg
- Hormonal imbalances between progesterone and estrogen
- The start of menstruation during puberty
- The end of menstruation during menopause
- Excessive weight loss* or weight gain
- Abnormalities of the thyroid gland
What are the Symptoms of Dysfunctional Uterine Bleeding?
- Irregular bleeding at different times in a woman’s ovulation cycle
- Light flow during menstruation or extremely heavy flow with clots
- Some patients experience uterine cramps
- Hot flashes
- Mood swings
- Dryness of the vagina
- Spotting in between menstruation
How is Dysfunctional Uterine Bleeding Diagnosed?
- The first step in diagnosing dysfunctional uterine bleeding is ruling out other conditions that may be causing the bleeding such as a miscarriage and fibroids.
- A pregnancy test is performed to check if the patient is pregnant.
- A blood count is also performed to check for anaemia due to excessive loss of blood.
- A hormone profile for the following hormones is performed in order to diagnose dysfunctional uterine bleeding: estrogen, progesterone, prolactin, androgens, Follicle Stimulating Hormone and Luteinising Hormone.
- A pap smear may also be performed to check for cervical infections.
- A transvaginal ultrasound is also essential in the diagnosis of dysfunctional uterine bleeding in order to thoroughly examine the pelvic area.
Treatment and Management
- In cases where dysfunctional uterine bleeding is moderate, for instance where a woman has just hit puberty, treatment may not be required.
- Birth control* pills particularly progesterone only pills are prescribed to control* uterine thickening hence manage dysfunctional uterine bleeding.
- Intrauterine devices (IUDs) which release the hormone progestin are also a good treatment option.
- Iron supplements are also prescribed for women who have acquired anaemia due to excessive loss of blood.
- Women who are not interested in getting children and have severe symptoms can always opt for more drastic measures such as the surgical removal of the uterus (hysterectomy).
What are the Possible Complications associated with Dysfunctional Uterine Bleeding?
Women suffering from dysfunctional uterine bleeding are at risk especially without treatment as they can suffer from the following complications:
- Severe anaemia due to excessive loss of blood. This can also lead to more problems such as shock.
- Infertility is very likely among these women. This is because this condition is more often than not characterised by failure to ovulate.
- Women who suffer from dysfunctional uterine bleeding have a higher chance of acquiring endometrial cancer compared to their healthy counterparts.
How Does this Condition Affect Female Sexual Health?
Dysfunctional uterine cancer can have negative effects on the female sexual health. The condition is characterised by failure of ovulation. This is particularly painful for women who wish to get children. Therefore, it can lead to depression, loss of interest in sex and desperation which leads to seeking remedies from people who are not even qualified in the first place.
Dysfunctional uterine bleeding also wreaks havoc to a woman’s menstrual cycle making it unpredictable. This means that a woman cannot always tell when her menses will commence, when they will stop* and how many times in a month they will occur. This leads to uncertainty particularly about sexual intercourse.
Dysfunctional uterine bleeding is as a result of hormonal imbalances. Hormones are crucial for a healthy reproductive system in women. An imbalance can lead to mood swings, anxiety, depression and vaginal drying which makes sexual intercourse painful and uncomfortable.
Unfortunately, dysfunctional uterine bleeding cannot be prevented. However, measures can be taken to prevent this disease from taking over a woman’s life. These include going for regular gynaecological check-ups, getting a professionally done hormone profile before taking oral contraceptives and keeping your weight under control*.