Dysfunctional uterine bleeding epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Around 3%-30% of women worldwide are affected by dysfunctional uterine bleed. A majority of cases occur either at menarche or near menopause. during this time, the imbalance between estrogen and progesterone is treated, leading to abnormal bleeding patterns. In younger girls, an immature hypothalamic axis contributes to the conditions well.
Epidemiology and Demographics
Worldwide, the incidence of women affected by dysfunctional uterine bleeding is estimated to be around 3%-30%. It is more common for cases to occur around menarche when the menstrual cycle initially begins or around menopause when the natural menstrual cycle is nearing its end.[1] Of the women affected, 25% are in their reproductive ages.[2] Over 80% of patients experiencing with menorrhagia presenting with some sort of underlying cause of dysfunctional endometrial bleeding.[3]
- In the UK, uptown 800,000 women present with abnormal uterine bleeding every year.[2]
- A study done in Turkey showed that the average age of affected patients was 15 years and almost 63% had at least one episode of irregular bleeding.[4]
The epidemiology of DUB can also be divided up based upon the underlying causes.
- Polyps occur in all ages but are most common amongst the ages of 40-49. The prevalence is 20%-40%. As many women go undiagnosed, 10% of cases are found upon autopsy while confirming death from another cause.[5] Polyps are less likely to be makignant in premenopausal women but have an increased incidence of malignancy in those that are postmenopausal.
- Adenomyosis has a prevalence of 20%-35% and most often affect women in their 30's and 40's. Women younger than 30 can experience a rare form of adenomysosis referred to as "juvenile cystic adenomyosis". This presents with extensive loss of blood inside endometrial cysts.[6] 70% of women affected are premenopausal. The disease varies widely amongst racial and ethnic groups as well as amongst different geographical regions[7]
- Leiomyoma is seemingly more common than would be expected. By the age of 50, approximately 70% of Caucasian women and 80% of African women will have experienced uterine bleeding due to leiomyoma. Black women experience symptoms twice compared to Caucasians.[8]
- In the United States, approximately 65,000 women are diagnosed with uterine cancer annually of which more than 90% are of endometrial origin. Death due to uterine malignancy is most common between the ages of 65-74 leading to a high mortality rate. The mortality rate is furthered in the elderly due to aggressiveness of the tumour, advancement of the disease upon initial presentation, and decreased compliance for surgical treatment owing to older age and other co-morbidities.[9]
- Worldwide, the prevalence of endometriosis is approximately 11,000 per 100,000 females in reproductive age group.[10] Endometriosis accounts for 33,000 per 100,000 cases with chronic pelvic pain and 17,000 per 100,000 cases with infertility.[11]
- Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in reproductive-age women, with a prevalence of 4-12% in the United States. Up to 10% of women are diagnosed with PCOS. The prevalence among first-degree relatives of patients with PCOS is 25% to 50%, suggesting a strong inheritance of the syndrome.
References
- ↑ "StatPearls". 2022. PMID 30422508.
- ↑ 2.0 2.1 Whitaker L, Critchley HO (2016). "Abnormal uterine bleeding". Best Pract Res Clin Obstet Gynaecol. 34: 54–65. doi:10.1016/j.bpobgyn.2015.11.012. PMC 4970656. PMID 26803558.
- ↑ Cameron IT (1989). "Dysfunctional uterine bleeding". Baillieres Clin Obstet Gynaecol. 3 (2): 315–27. doi:10.1016/s0950-3552(89)80024-0. PMID 2692922.
- ↑ Demir SC, Kadayýfçý TO, Vardar MA, Atay Y (2000). "Dysfunctional uterine bleeding and other menstrual problems of secondary school students in Adana, Turkey". J Pediatr Adolesc Gynecol. 13 (4): 171–5. doi:10.1016/s1083-3188(00)00061-9. PMID 11173019.
- ↑ "StatPearls". ( ). 2022: . PMID 32491756 Check
|pmid=value (help). - ↑ "StatPearls". ( ). 2022: . PMID 30969690.
- ↑ Taran FA, Stewart EA, Brucker S (2013). "Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy". Geburtshilfe Frauenheilkd. 73 (9): 924–931. doi:10.1055/s-0033-1350840. PMC 3859152. PMID 24771944.
- ↑ "StatPearls". ( ). 2022: . PMID 30855861.
- ↑ "StatPearls". ( ). 2022: . PMID 32965984 Check
|pmid=value (help). - ↑ Buck Louis, Germaine M.; Hediger, Mary L.; Peterson, C. Matthew; Croughan, Mary; Sundaram, Rajeshwari; Stanford, Joseph; Chen, Zhen; Fujimoto, Victor Y.; Varner, Michael W.; Trumble, Ann; Giudice, Linda C. (2011). "Incidence of endometriosis by study population and diagnostic method: the ENDO study". Fertility and Sterility. 96 (2): 360–365. doi:10.1016/j.fertnstert.2011.05.087. ISSN 0015-0282.
- ↑ McDonald JS (2001). "Diagnosis and treatment issues of chronic pelvic pain". World J Urol. 19 (3): 200–7. PMID 11469608.