Dysfunctional uterine bleeding pathophysiology

Dysfunctional uterine bleeding Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. Associate Editor(s)-in-Chief: Arooj Naz

Overview

Dysfunctional uterine bleeding is a condition that affects many women worldwide, especially because it has a wide range of underlying causes.

Pathophysiology

Dysfunctional uterine bleeding can be classified into acute and chronic causes.

1. Acute Dysfunctional uterine bleeding

• Acute bleeding can develop in one of two ways. Either bleeding can develop acutely on which immediate intervention is required to prevent excessive blood loss, or it can be imposed upon chronic uterine bleeding. The latter often refers to menstrual irregularities that developed of 6 months or longer.

1. Chronic Dysfunctional uterine bleeding

• At the end of the menstrual cycle, progesterone levels fall significantly leading to a breakdown of the functional layer of the endometrium. This leads to the phenomenon known as the menstrual cycle. This cycle can become irregular due to several causes, especially any derangements in the architectural structure of the endometrium. Common underlying causes include polyps, adenomyosis, leiomyoma, malignancy or hyperplasia, coagulopathies, ovulatory dysfunction, endometrial disorders and iatrogenic causes. DUB that is due to underlying ovulatory causes occurs due to defects in local endometrial functions whereas anovulatory is often due to systemic disorders, endocrine or neurological imbalances. By understanding the pathophysiology of these conditions, one can understand the cause of dysfunctional uterine bleeding.

Polyp

Adenomyosis

Leiomyoma

Malignancy and hyperplasia

Coagulopathy

Ovulatory dysfunction

Endometrial disorders

Iatrogenic

Ovulatory

Anovulatory