Dysfunctional uterine bleeding.

Dysfunctional uterine bleeding (DUB) is a common gynecologic problem, occurring most frequently at the extremes of a woman's reproductive life. The primary cause of DUB is anovulation; however, because DUB is a diagnosis of exclusion, a detailed history and a thorough physical and pelvic examination with appropriate diagnostic tests are essential in order to rule out other pathologic causes of abnormal uterine bleeding. Knowledge of the physiologic basis, differential diagnoses, and diagnostic and management modalities for DUB enables the nurse practitioner to provide optimal care for the patient.