Dysfunctional Uterine Bleeding - now what?

[snakemed@aol.com]

Hello everyone,

I am looking for any support advice, will try to explain but keep it brief - I am 38 years old, living in UK. I have been experiencing heavy uterine bleeding and pelvic pain in the past year - no issues previously. No children and have never been pregnant.
Treatment has been tranexamic acid to reduce bleeding, went for transvaginal ultrasound and then a hysteroscopy for a suspected polyp. Had to go back in January for hysteroscopy under GA, no polyp was found, but the heavy bleeding continued and I was off work for 4 months suffering pain and bleeding.
GP started me on norithisterone tablets which have stopped the bleeding and referred me back to Gynae clinic. AM not on waiting list for Endometrial Ablation. Diagnosis sounds rather vague - Dysfuctional Uterine Bleeding. Have returned to work but am struggling - womb pain still an issue.
Has anyone else experienced similar? Will the Ablation help me and why is my womb still hurting when I am not heavily bleeding?

Many thanks

Laura

[athena123456]

Dysfunctional uterine bleeding (DUB) is a medical term used to describe abnormal bleeding from the uterus that is not caused by a structural or organic disorder. It is a diagnosis of exclusion, meaning that other possible causes of abnormal uterine bleeding, such as hormonal imbalances, uterine fibroids, polyps, or certain medical conditions, have been ruled out.

DUB typically occurs due to hormonal imbalances, specifically involving the reproductive hormones estrogen and progesterone. These imbalances can disrupt the normal menstrual cycle and lead to irregular, heavy, or prolonged bleeding.

The exact cause of hormonal imbalances leading to DUB is often unclear. However, several factors may contribute to its development, including:

Puberty and perimenopause: During these transitional phases of a woman's reproductive life, hormonal fluctuations are common and can result in irregular menstrual cycles and DUB.

Anovulation: When ovulation does not occur in a menstrual cycle, it can disrupt the usual hormonal pattern and lead to DUB.

Polycystic ovary syndrome (PCOS): PCOS is a condition characterized by hormonal imbalances, often involving increased levels of androgens (male hormones). These imbalances can lead to irregular periods and DUB.

Thyroid disorders: An underactive or overactive thyroid gland can affect hormone levels and contribute to abnormal uterine bleeding.

Medications: Certain medications, such as hormonal contraceptives or blood-thinning agents, can cause DUB as a side effect.

The symptoms of DUB can vary but commonly include heavy or prolonged menstrual bleeding, irregular menstrual cycles, bleeding between periods, and unpredictable spotting. DUB can lead to anemia if the bleeding is severe and prolonged.

Diagnosis of DUB involves a thorough medical history review, a physical examination, and various tests to rule out other potential causes of abnormal bleeding. These tests may include blood tests to assess hormone levels, a pelvic ultrasound to evaluate the uterus and ovaries, and sometimes an endometrial biopsy to examine the tissue lining the uterus.

Treatment for DUB depends on the severity of symptoms, the woman's age, desire for future fertility, and other individual factors. Options may include:

Hormonal therapy: Birth control pills, hormonal intrauterine devices (IUDs), or other hormone medications may be prescribed to regulate the menstrual cycle and reduce bleeding.

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications, such as ibuprofen, can help reduce menstrual pain and decrease blood flow.

Endometrial ablation: This minimally invasive procedure destroys the lining of the uterus, reducing or eliminating menstrual bleeding. It is typically recommended for women who no longer desire future fertility.

Hysterectomy: In severe cases or when other treatments have failed, surgical removal of the uterus may be considered.

It's important to consult with a healthcare provider for a proper diagnosis and to discuss the most appropriate treatment options for DUB. They can evaluate your specific situation and provide personalized recommendations to manage the condition effectively.