Abnormal uterine bleeding (clinical lecture)

Abstract

Abnormal uterine bleeding (AUB) not related to pregnancy has been one of the leading reasons for visiting a gynecologist for many years. The incidence of AUB is approximately 30% among patients of reproductive age and can increase to 70% during the perimenopausal period. Recurrent AUB leads to the development of iron deficiency anemia, significantly reducing the quality of life, and also resulting in additional costs for hygiene products.

This clinical lecture provides a modern classification of AUB. It focuses on the main mechanisms of development of this pathology in adolescence and reproductive age. The causes of AUB are analyzed, and the classification, symptomatology, and clinical presentation of the studied conditions are presented. The lecture covers international criteria for pathologic uterine bleeding, clinical criteria for assessing bleeding severity according to Mansfield–Vode–Jorgensen scale and estimation of blood loss volume according to Algover index. Detailed consideration is given to the issues of differential diagnosis, general principles of therapy, and indications for traditional, hormonal, and surgical hemostasis. The lecture also outlines the algorithm of diagnostic search for patients in the adolescent, reproductive, postmenopausal age groups, as well as for patients on the background of menopausal hormonal therapy.

Keywords

abnormal uterine bleeding (AUB) / reproductive period / menopause / diagnosis

References

[1] Savel’eva GM, Sukhikh GT, Serov VN, Radzinskii VE, Manukhin IB, editors. Gynecology. National Leadership. 2nd ed., reprint. and add. Moscow: GEOTAR-Media; 2020. (In Russ).

[2] Гинекология. Национальное руководство / под ред. Г.М. Савельевой, Г.Т. Сухих, В.Н. Серова, В.Е. Радзинского, И.Б. Манухина. 2-е изд., перераб. и доп. Москва : ГЭОТАР-Медиа, 2020.

[3] Savel’eva GM, Apolikhina IA, Baranov II, Sukhikh GT, Serov VN. Obstetrics and Gynecology. Clinical Recommendations. 4th ed., reprint. and add. Moscow: GEOTAR-Media; 2019. (In Russ).

[4] Савельева Г.М., Аполихина И.А., Баранов И.И., Сухих Г.Т., Серов В.Н. Акушерство и гинекология. Клинические рекомендации. 4-е изд., перераб. и доп. Москва : ГЭОТАР-Медиа, 2019.

[5] Radzinskii VE, Khamoshina MB, Raevskaya OA, et al. Essays on Endocrine Gynecology. Moscow: StatusPraesens; 2020. (In Russ).

[6] Радзинский В.Е., Хамошина М.Б., Раевская О.А., и др. Очерки эндокринной гинекологии. Москва : StatusPraesens, 2020.

[7] Obstetrics and Gynecology. Textbook in 4 books. Book 4. Ishchenko AI, Unanyan AL, Sidorova IS, Nikitina NA, Chushkov YuV. Gynecology. Moscow: Medical Information Agency; 2019. (In Russ).

[8] Акушерство и гинекология. Учебник в 4 кн. Книга 4. Ищенко А.И., Унанян А.Л., Сидорова И.С., Никитина Н.А., Чушков Ю.В. Гинекология. Москва : Медицинское информационное агентство, 2019.

[9] Russian Society of Obstetricians and Gynecologists. Amenorrhea and Oligomenorrhea. Clinical Recommendations of the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ).

[10] Российское общество акушеров-гинекологов. Аменорея и олигоменорея. Клинические рекомендации Министерства здравоохранения РФ. Москва, 2021.

[11] Russian Society of Obstetricians and Gynecologists. Menopause and menopausal condition in women. Clinical Recommendations of the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ).

[12] Российское общество акушеров-гинекологов. Менопауза и климактерическое состояние у женщины: Клинические рекомендации Министерства здравоохранения РФ. Москва, 2021.

[13] Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists. Polycystic Ovary Syndrome: Clinical Recommendations of the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ).

[14] Российское общество акушеров-гинекологов, Российская ассоциация эндокринологов. Синдром поликистозных яичников: Клинические рекомендации Министерства здравоохранения РФ. Москва, 2021.

[15] Russian Association of Endocrinologists, Russian Society of Obstetricians and Gynecologists. Congenital Dysfunction of the Adrenal Cortex (Adrenogenital Syndrome): Clinical Recommendations of the Ministry of Health of the Russian Federation. Moscow; 2021. (In Russ).

[16] Российская ассоциация эндокринологов, Российское общество акушеров-гинекологов. Врождённая дисфункция коры надпочечников (адреногенитальный синдром): Клинические рекомендации Министерства здравоохранения РФ. Москва, 2021.

[17] Russian Association of Endocrinologists. Hyperprolactinemia: Clinical Recommendations of the Ministry of Health of the Russian Federation. Moscow; 2016. (In Russ).

[18] Российская ассоциация эндокринологов. Гиперпролактинемия: Клинические рекомендации Министерства здравоохранения РФ. Москва, 2016.

RIGHTS & PERMISSIONS

Eco-Vector