scholarly journals Abnormal Uterine Bleeding: a Focus on Polycystic Ovary Syndrome

2009 ◽  
Vol 5 (3) ◽  
pp. 313-324 ◽  
Author(s):  
Martha Hickey ◽  
Krish Karthigasu ◽  
Sweta Agarwal
Keyword(s):  
Polycystic Ovary ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Ovary Syndrome ◽  
Menopausal Women ◽  
Common Causes ◽  
Reproductive Life ◽  
The Common ◽  
Irregular Bleeding

Abnormal uterine bleeding imposes major medical, social and financial problems for women, their families and the health services. Abnormal uterine bleeding refers to the regularity, frequency, duration and volume of bleeding. Irregular menstrual bleeding is most common at the extremes of reproductive life, in the initial 12–18 months after menarche and 5–6 years before the menopause begins. In Australia, the estimated cost of investigating and managing heavy menstrual bleeding alone is approximately AUS $6 million per annum. This article addresses the common causes of irregular bleeding in pre- and peri-menopausal women and presents an investigational approach.

scholarly journals Clinical profile of 500 cases of Polycystic Ovary Syndrome in a Tertiary Hospital

2020 ◽  
Vol 33 (1) ◽  
pp. 45-48
Author(s):  
Nusrat Mahjabeen ◽  
Sk Zinnat Ara Nasreen ◽  
Faryl Mustary
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Abnormal Uterine Bleeding ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Menstrual Disturbances

Background: Polycystic ovary syndrome (PCOS) is a common condition affecting 4% to18% of women. It has been suggested that this condition occurs in as many as 4-10% ofwomen of reproductive age. PCOS is associated with significant reproductive morbidity,including infertility, abnormal uterine bleeding, miscarriage and other complications ofpregnancy. Method: This cross-sectional study was carried out in the Department of Obstetrics andGynaecology of Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January,2013 to December, 2016 over a period of 4 years with the objective to find out various clinicalpresentations, endocrine status, the menstrual abnormalities and sonographic findings ofthe patients with PCOS. During the study period a total number of 1600 patients wereexamined for infertility in the Outpatient and in Inpatient Department. Out of these 1600infertility patients, 500 cases were found to have polycystic ovary syndrome. Detailedinformation about the patients were collected in a predesigned data collection sheet. Result: Out of 500 PCOS patients, 360 (72.0%) had primary sub-fertility and 140 (28.0%)had secondary sub-fertility. Age of the patients ranged between 25 and 35 years. Duration ofinfertility was between 5 to 18 years. Prevalence of menstrual disturbances was found in78.0 percent of PCOS patients, of which & 90 (18.0%) had amenorrhoea, 250 (50.0%) hadoligomenorrhoea, 50 (10.0%) had a heavy menstrual bleeding and 110 (22.0%) had normalmenstrual cycle. Among those patients, 210 (42.0%) were obese, 230 (46.0%) had normalBMI and 60 (12.0%) were under weight. Conclusion: The prevalence of PCOS in this study was 31.25% among infertility patients.Among them 72.0% had primary sub-fertility and 28.0% had secondary sub-fertility. Prevalenceof menstrual disturbances was found in 78.0% of PCOS patients, of which 18.0% hadamenorrhoea, 50.0% had oligomenorrhoea and 10.0% had heavy menstrual bleeding. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 45-48

scholarly journals MANAGEMENT OF ASRIGDARA THROUGH VIRECHANA KARMA

2021 ◽  
pp. 82-86
Author(s):  
Khushboo Jha ◽  
Subhadra ◽  
K. Bharathi ◽  
Sonu
Keyword(s):  
Blood Flow ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Single Patient ◽  
Dysfunctional Uterine Bleeding ◽  
Organic Lesion ◽  
Menopausal Women ◽  
Effective Role ◽  
Irregular Bleeding

Dysfunctional uterine bleeding is a state of Abnormal uterine bleeding (AUB) without any clinically detectable organic, systemic & iatrogenic cause (pelvic pathology like tumor, inflammations excluded). DUB represents a particular type of AUB and is defined as excessive, prolonged and irregular bleeding of endometrium with frequency less than 21 days, duration more than seven days that does not cause pain and does not involve any organic lesion. Based on the clinical features it can be compared with Asrigdara mentioned in Ayurvedic classics. Asrigdara is one of the commonly met problems in Gynae OPD among peri menopausal women. One half of women among the AUB will have DUB. 10 – 15% of women experience episodes of DUB at some time during their reproductive age. This study was conducted in a single patient. A lady of age 41 years, having problem of prolonged bleeding since one and half years came to OPD of Prasuti and Stri roga, National Institute of Ayurveda, Jaipur. She had taken hormonal preparations and haemostatics for five continuous months along with D& C done for same problem, after wards bleeding increased even more and then doctors have given hysterectomy advice as the last resort. Patient was posted for Virechan Karma as classical schedule owing to her Agni and Vyayamshakti. Snehapan was done by plain Go Ghrita and Virechan was done by Trivritalehyam. Followed by few oral medicines after Samsarjana Karma. The patient was followed up for three months. There is significant reduction in amount of blood flow along with increased inter – menstrual period. Thus, we can conclude from the study that Ayurveda regimen plays an effective role in management of Asrigdara.

STUDY OF DIAGNOSTIC HYSTEROSCOPY IN PERI AND POSTMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

2021 ◽  
pp. 9-12
Author(s):  
Surbhi Sharma ◽  
Kushla Pathania ◽  
Rama Thakur
Keyword(s):  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
P Value ◽  
Care Hospital ◽  
Prolonged Bleeding ◽  
Menopausal Women ◽  
Post Menopausal

Background:Abnormal uterine bleeding is dened as bleeding from uterus that differs from that of usual normal menstrual bleeding, in frequency of occurrence or in amount or in alteration of ow. The advantages of hysteroscopy as an accurate diagnostic technique are that it not only allows direct visual observation of pathology but also provides a means to sample the site, most likely to yield positive results. The present study was conducted to study the role of Hysteroscopy in abnormal uterine bleeding in Peri and Post-menopausal women at a tertiary care hospital. Material And Methods: Present study was single-center, prospective, Cross sectional study, conducted in women age ≥40years with heavy menstrual bleeding, prolonged bleeding, frequent menstruation, intermenstrual bleeding and post coital bleeding, Post-menopausal bleeding. Hysteroscopy was performed preferably in post-menstrual phase or post bleeding phase with a standard 4mm hysteroscope(Stryker) with a 30 degree fore-oblique lens. Procedure was performed under IV sedation with normal saline as distention media. Results: In present study, majority of the subjects (n=28) i.e. 36.8% presented with heavy menstrual bleeding followed by prolonged bleeding (32.8%), post- menopausal bleeding (21%), frequent menstruation (7.89%) and inter-menstrual bleeding (1.3%). On hysteroscopy normal ndings were present in 32 subjects (42%) followed by hyperplasia (17.1%), atrophic endometrium (13.1%), submucous broid (14.4%), endometrial growth (2.96%) & broid polyp (1.36%). Histopathology examination noted Proliferative endometrium (31.5%), secretory (10.5%), disordered proliferative phase (1.3%), simple hyperplasia (18.4%), complex hyperplasia with atypia (1.3%), submucous broid (14.4%), endometrial polyp (34.2%), atrophy (13.1%), broid polyp (1.34%) and malignancy (3.96%). Sensitivity, Specicity, PPV, NPV values were 100 % except for sensitivity for endometrial growth (66.7 %). p Value was highly signicant for all parameters (p <0.0001) Conclusion: Hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.. The intracavitary lesions (submucous leiomyomas, polyps, endometrial growth are) better diagnosed on hysteroscopy

scholarly journals Abnormal uterine bleeding in perimenopausal age group women: a study on clinicopathological evaluation and management

2017 ◽  
Vol 7 (1) ◽  
pp. 192
Author(s):  
Sreelakshmi U. ◽  
Tushara Bindu V. ◽  
Subhashini T.
Keyword(s):  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Endometrial Tissue ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Age Group ◽  
Histopathological Findings ◽  
Number Of Patients ◽  
Perimenopausal Women

Background: Abnormal uterine bleeding is the most common and frequent presenting complaint in Gynaecology Outpatient Department in all age groups, especially in perimenopausal women. Objective of present study was clinicopathological evaluation and management of abnormal uterine bleeding in perimenopausal age group women.Methods: The present study was prospective analytical study conducted at Mallareddy Narayana Multi-speciality Hospital, reputed teaching hospital, in Obstetrics and gynaecology department in association with department of pathology from January 2015 to December 2016. Perimenopausal women in age group 45-55 years included in this study. Other age groups with abnormal uterine bleeding, isolated cervical or vaginal pathology, bleeding diathesis, and pregnancy related causes of bleeding excluded from this study. Endometrial tissue collected by sampling procedure such as dilatation and curettage. Proper counselling about management was given to all women related to medical and surgical interventional approaches.Results: A total of 135 women with abnormal uterine bleeding in perimenopausal age were examined after fulfilling criteria during study period of 2 years. The age of participants in mean±SD was 46.68±2.03 years (min 45 years and max 55 years). Maximum number of patients with abnormal uterine bleeding presented in age group of 45-50 years. The most common symptoms were heavy menstrual bleeding (83.7%), followed by frequent menstrual bleeding (26.6%). Proliferative endometrium was the most common histopathological (30.3%) study followed by secretory endometrium (27.4%). Surgical management was given to 94 patients.Conclusions: Heavy menstrual bleeding and frequent menstrual bleeding were mostly correlated with abnormal endometrial histopathological findings in this study. Gynaecologists should pay attention towards these abnormal bleeding patterns along with the evaluation of endometrial tissue for histopathological findings, which will help us to plan for successful management. 

scholarly journals Histopathological evaluation of endometrial sampling in perimenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (8) ◽  
pp. 3180
Author(s):  
Bhavani L. Nair ◽  
Lency S. Kuriakose
Keyword(s):  
Endometrial Cancer ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Endometrial Sampling ◽  
Medical College ◽  
Perimenopausal Women ◽  
Proliferative Endometrium ◽  
Secretory Endometrium

Background: Abnormal uterine bleeding (AUB) is one of the common symptoms in the gynaecology outpatient department. About one third of women are affected at some time in their lives. The perimenopausal women show significant number of underlying organic pathology. The evaluation of endometrium and/or organ histopathology has the dual advantage of finding the cause of AUB and to rule out endometrial cancer or the potential for cancer in future like endometrial hyperplasia with atypia. The aim of the study was to determine the histopathological pattern of endometrial sampling in perimenopausal women with AUB and to follow them up for a period of six months after the procedure.Methods: The prospective observational study was conducted at the department of obstetrics and gynaecology at Sree Gokulam Medical College and Research Foundation, Venjaramood, Thiruvananthapuram, Kerala, for a period of one year from December 2019 to December 2020. The study was conducted on 116 perimenopausal women 41-52 years who presented with AUB and had undergone endometrial sampling. These ladies were subsequently followed up for six months post procedure to assess the response to medical treatment or the need for any surgical intervention like hysterectomy.Results: A total 39.65% patients had heavy and prolonged menstrual bleeding and 18.16% patients had irregular bleeding. 14.65% patients had prolonged flow, 8.6% had heavy flow, 6.8% had infrequent with prolonged flow, 6% had prolonged, infrequent with heavy bleeding. Non-structural (COEIN) causes contributed to about 60.4% of AUB in perimenopausal women and 39.6% had structural (PALM) causes. 49% cases were secretory endometrium. 29.3% had disordered proliferative endometrium, 4.3% had proliferative endometrium, 5.2% each had polyp or hyperplasia without atypia. 18 (15.5%) cases underwent hysterectomy, 3 patients who had adenocarcinoma underwent staging laparotomy, 2 patients had LNG IUS insertion and 40 patients were on follow up requiring either no treatment and 53 (45.68%) patients were given antifibrinolytics or hormonal therapy.Conclusions: Heavy and prolonged menstrual bleeding was the most common presenting symptom. COEIN contributed to about 60.4% of cases. Evaluation of the endometrium showed that, secretory endometrium was commonest (49%) followed by disordered proliferative endometrium (29.3%). On follow up for six months, 15.5% patients underwent hysterectomy, 2 patients had insertion of levonorgestrel IUD, 45.68% patients had medical management with antifibrinolytics or hormones and were on follow up. The responsibility of gynaecologist in the management of AUB in perimenopausal women is to exclude hyperplasia of endometrium and endometrial cancer.

scholarly journals Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

2021 ◽  
Vol 10 (10) ◽  
pp. 3885
Author(s):  
Kushla Pathania ◽  
Surbhi Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Postmenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Predictive Values ◽  
Menopausal Women ◽  
Submucous Fibroid ◽  
Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

Abnormal Uterine Bleeding in Pre-Menopausal Women

2013 ◽  
Vol 35 (5) ◽  
pp. S1-S3 ◽  
Author(s):  
Sukhbir Singh ◽  
Carolyn Best ◽  
Sheila Dunn ◽  
Nicholas Leyland ◽  
Wendy Lynn Wolfman ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menopausal Women

Polycystic ovary syndrome and nephrotic syndrome. Common causes for premature cardiovascular disease?

2018 ◽  
pp. 669-669
Author(s):  
Paweł Tyczyński ◽  
Justyna Norwa ◽  
Ewa Rudnicka ◽  
Maria Wieteska ◽  
Piotr Duchnowski ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Nephrotic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Premature Cardiovascular Disease ◽  
Common Causes
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