Practice Bulletin No. 136: Management of Abnormal Uterine Bleeding Associated With Ovulatory Dysfunction

@article{2013PracticeBN,
  title={Practice Bulletin No. 136: Management of Abnormal Uterine Bleeding Associated With Ovulatory Dysfunction},
  author={},
  journal={Obstetrics \& Gynecology},
  year={2013},
  volume={122},
  pages={176–185}
}
  • Published 2013
  • Medicine
  • Obstetrics & Gynecology
Definition and Nomenclature Abnormal uterine bleeding associated with ovulatory dysfunction (AUB-O) (ie, oligo-ovulation or anovulation) is a spectrum of disorders most commonly associated with heavy, irregular uterine bleeding. Abnormal uterine bleeding (AUB) occurs in the setting of ovulatory dysfunction because of the effects of chronic unopposed estrogen on the endometrium. Abnormalities at any level of the hypothalamic–pituitary–ovarian axis can result in interruption of the ovulatory… Expand
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Involvement of Adenomyosis in Refractory Abnormal Uterine Bleeding-Ovulatory Dysfunction: A Case Series
  • 2021
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TLDR
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TLDR
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TLDR
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References

SHOWING 1-10 OF 72 REFERENCES
Clinical manifestations and treatment of dysfunctional uterine bleeding.
TLDR
The goals of treatment for anovulatory bleeding are to stop the acute bleeding, avert future episodes, and prevent long-term complications. Expand
Progestogens with or without oestrogen for irregular uterine bleeding associated with anovulation.
TLDR
No randomised trials were identified that compared progestogens with oestrogens and progestogen or with placebo in the management of irregular bleeding associated with oligo/anovulation. Expand
FIGO classification system (PALM‐COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age
TLDR
The PALM‐COEIN (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified) classification system for AUB is presented. Expand
The levonorgestrel intrauterine system is an effective treatment in selected obese women with abnormal uterine bleeding.
TLDR
In properly selected obese women with AUB, the LNG-IUS is an effective therapy in approximately 75% of cases. Expand
Ultrasonography-based triage for perimenopausal patients with abnormal uterine bleeding.
TLDR
Nondirected office biopsy alone without imaging would have potentially missed the diagnosis of focal lesions such as polyps, submucous myomas, and focal hyperplasia in up to 80 patients (18%). Expand
Clinical outcomes and costs with the levonorgestrel-releasing intrauterine system or hysterectomy for treatment of menorrhagia: randomized trial 5-year follow-up.
TLDR
By providing improvement in HRQL at relatively low cost, the LNG-IUS may offer a wider availability of choices for the patient and may decrease costs due to interventions involving surgery. Expand
Quality of life and cost-effectiveness of levonorgestrel-releasing intrauterine system versus hysterectomy for treatment of menorrhagia: a randomised trial
TLDR
A randomised comparison of the levonorgestrel-releasing intrauterine system with hysterectomy in terms of the quality of life of women with menorrhagia and cost-effectiveness shows a significant improvement in health-relatedquality of life. Expand
The significance of an 'insufficient' Pipelle sample in the investigation of post‐menopausal bleeding
TLDR
Results do not support the initial hypothesis that an 'insufficient' Pipelle sample reliably reflected the absence of serious endometrial pathology, but suggest that in women presenting with post-menopausal bleeding, an ' Insufficient' sample is an indication for further investigation. Expand
Accuracy of hysteroscopy in the diagnosis of endometrial cancer and hyperplasia: a systematic quantitative review.
TLDR
The diagnostic accuracy of hysteroscopy is high for endometrial cancer, but only moderate forendometrial disease (cancer or hyperplasia), and the results were heterogeneous. Expand
Accuracy of preoperative diagnostic tools and outcome of hysteroscopic management of menstrual dysfunction.
TLDR
Operative hysteroscopy is a safe outpatient procedure and is associated with high satisfaction in carefully selected patients and Hysteroscopy and SIS are better diagnostic tests for intracavitary abnormalities than TVS and endometrial biopsy. Expand
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