Dysfunctional uterine bleeding.

Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. It may be associated with ovulatory and anovulatory cycles. The diagnosis of DUB depends on a thorough history and physical examination to exclude organic disorders. In older women, endometrial biopsy should be done before starting therapy. The treatment depends on an understanding of the menstrual cycle. In less urgent cases, anovulatory cycles are managed using progesterone replacement, and ovulatory cycles respond well to non-steroidal anti-inflammatory drugs (NSAIDs). In urgent cases oral or intravenous estrogen is used, and emergency dilation and currettage are done if the hemorrhage fails to stop.