Dysfunctional uterine bleeding DUB

• Facts:
  Heavy vaginal bleeding in the absence of structural or organic disease
  Usually from anovulation
• History / PE:
  Heavy vaginal bleeding
  Anemia
  
• Diagnosis:
  Diagnosis of exclusion
  Negative pregnancy test
  Normal ultrasound
• Treatment:
  Iron supplementation (mild cases)
  Progestin (moderate, no active bleeding)
  High dose estrogen therapy (severe, active bleeding)
  
  **In women > 35 years old with DUB, perform endometrial biopsy
• Notes:
  Most common cause of abnormal uterine bleeding