Abnormal Uterine Bleeding (AUB)

Abnormal Uterine Bleeding (AUB) is where there are irregularities from a normal menstrual cycle – Includes frequency, duration, cycle length, volume of menses. AUB indicates anovulation or irregular ovulation.

If it occurs between well-defined menstrual cycles, it's called Intermenstrual bleeding.

If it’s related to hormonal changes that directly affect the menstrual cycle, it's called Dysfunctional Uterine bleeding.

Causes

Structural:

• Polyps – endometrial, cervical

• Adenomyosis

• Fibroid

• Malignancy

Non-structural:

• Coagulopathy

• Ovulatory dysfunction

• Endometrial disorders

• Iatrogenic

Investigations

• Bedside – Cervical smear

• Bloods – FBC

• Special – Pelvic US, Pelvic infection screening, Hysteroscopy and biopsy, MRI

It's important to rule out pregnancy! and any red flags e.g. cancer.