Most common cause of Dysfunctional Uterine Bleeding:

Ans. (d) AnovulatoryRef.: Shaws 15th ed. 1301-307* Dysfunctional uterine bleeding is irregular, abnormal uterine bleeding that is not caused by a tumor, infection or pregnancy.* Dysfunctional uterine bleeding is a disorder that occurs most frequently in women at the beginning and end of their reproductive lives.* It is of 2 types:* Ovulatory: after adolescent years and before perimenopausal years.* Anovulatory: postmenarcheal, premenopausal.* Half of the cases occur in women over 45 years of age and about one fifth occur in women under age 20.* Dysfunctional uterine bleeding is diagnosed when other causes of uterine bleeding have been eliminated.* Failure of the ovary to release an egg (anovulatory) during the menstrual cycle occurs in about 70% of women with DUB. This is probably related to a hormonal imbalance.Also Know* Normal menstruation duration: 28 +/- 7 days, mean of 4 days duration, not more than 7 days* Menorrhagia or hypermenorrhea: prolonged (>7 days) or excessive (>80 ml) bleeding at regular intervals* Metrorrhagia: bleeding in irregular but frequent intervals, variable amount* Menometrorrhagia: prolonged bleeding at irregular intervals* Polymenorrhea: bleeding in regular intervals <21 days* Oligomenorrhea: regular intervals > 35 daysEndometriosisAdenomyosis* It is also a cause of DUB.* Presence of endometrium outside uterus.* MC site: ovary Rarest site: CNS* In ovary, it present at chocolate cyst ovary.* Present with menorrhagia, pain, Infertility.* MC symptom: Congestive Dysmenorrhea.* Gold standard Inv: Laparoscopy (diagnostic + therapeutic)* Also a cause of DUB* Presence of endometrial gland in myometrium* Seen in patients around 40 years.* Present with menorrhagia, dysmenorrhea and pain BUT no Inftertility.* Uterus is tender and enlarged: 12-14 week size.* Diagnosed with Histopathology.* Treatment of choice: Hysterectomy