Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the vagina that is due to changes in hormone levels. It is bleeding that is NOT caused by: Pregnancy or miscarriage. Medical conditions, such as cancer or fibroids. Problems with the uterus or vagina from infection or other causes
It is classified as:
Menorrhagia: Excessive menstrual loss in amount or duration or both. This is the commonest type of DUB
Metrorrhagia: Bleeding occurs irregularly between menstrual cycle.
Dysmenorrhea: Painful menstruation
Ovulatory dysfunction amounts for 30% cases of infertility
It is characterized by abnormal, irregular or absence of ovulation. Menses are often irregular or absent
Polycystic ovarian disease is the most common cause of ovulatory dysfunction
Other causes include hypothalamic disorder, hyperprolactinemia etc
Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder that affects approximately 5 to 10% of women of reproductive age. It is characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance, hyperinsulinemia, abdominal obesity, hypertension, and dyslipidemia as frequent metabolic traits (metabolic syndrome) that culminate in serious long-term consequences such as type 2 diabetes mellitus, endometrial hyperplasia, and coronary artery disease. It is one of the most common causes of anovulatory infertility.
The heterogeneous clinical features of PCOS may change throughout the life span, starting from adolescence to postmenopausal age. These are largely influenced by variation in obesity and metabolic changes. They are also affected by the varied phenotype of women with PCOS, depending on the ethnic backgrounds. Irrespective of geographic locations, a rapidly increasing prevalence of polycystic ovarian insulin resistance syndrome, excess body fat, adverse body fat patterning, hypertriglyceridemia, and obesity-related disease, such as diabetes and cardiovascular disease, have been reported in Asian Indians, suggesting that primary prevention strategies should be initiated early in this ethnic group.
Obesity contributes to the increased prevalence and severity of PCOS. To treat PCOS, it is recommended to limit the total energy and dietary fat intake. Hypocaloric diets significantly led to reduced body weight and androgen levels in two groups of women with PCOS. The combination of high-protein and low-glycemic-load foods in a modified diet was found to cause a significant increase in insulin sensitivity when compared with a conventional diet.
PCOS improves with weight loss. Meal replacements are an effective strategy for the short-term management of PCOS. A moderate fat or carbohydrate restriction has been found equally effective in maintaining weight reduction and improving reproductive and metabolic variables.
Hyperprolactinemia is the presence of abnormally high levels of prolactin in the blood of women who are not pregnant and in men
About a third of women in their childbearing years with irregular periods but normal ovaries have hyperprolactinemia.
25.5% of primary infertility and 21.31% of secondary infertility females showed hyperprolactinemia
It is a gynaecological condition in endometrium appear and flourish outside the uterine cavity, most commonly on the membrane which lines the abdominal cavity, the peritoneum.
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also, called leiomyomas or myomas, uterine fibroids aren’t associated with an increased risk of Uterine cancer and almost never develop into cancer.