1. Menstrual Disorders:
Dysfunctional Uterine Bleeding
Health Services
TasTAFE Health Services
www.tastafe.tas.edu.au
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2. Dysfunctional Uterine Bleeding
Dysfunctional uterine bleeding is a term
describing irregular, abnormal bleeding that
is not caused by pregnancy, tumor, or
infection
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3. Dysfunctional Uterine Bleeding
Dysfunctional uterine bleeding occurs at the
beginning and end of a woman’s reproductive
years and is caused by an absence of ovulation;
therefore, progesterone is not produced.
This lack of ovulation and progesterone creates
a hyperproliferative state that results in
excessive bleeding due to the irregular
shedding of the uterine lining.
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4. Dysfunctional Uterine Bleeding:
Types
 Amenorrhea: (absence of menstruation)
 Hypomenorrhea: (scanty menstruation)
 Oligomenorrhea: (infrequent
menstruation, periods more than 35 days apart)
 Menorrhagia: (excessive menstruation),
 Metrorrhagia: (bleeding between periods).
 Menometrorrhagia: (is heavy bleeding during
and between menstrual periods).
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5. Dysfunctional Uterine Bleeding:
Causes
Secondary dysmenorrhea is:
IUCD
Polysystic ovary syndrome
Morbid obesity
Steroid therapy
Hypothyroidism
Clotting disorders
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6. Dysfunctional Uterine Bleeding: Signs
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vaginal bleeding between periods
irregular menstrual cycle
infertility
mood swings
hot flashes
vaginal tenderness
menstrual flow either scanty or profuse
obesity
acne
diabetes: insulin resistance is common
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7. Dysfunctional Uterine Bleeding: Assessment

Patient history

Physical examination:
• assist in pelvic examination to identify any
structural abnormalities

Laboratory tests:
• CBC to reveal anemia
• PT to detect blood disorders
• BHCG to rule out abortion or ectopic
pregnancy
• TSH to screens for hypothyroidism
• Transvaginal ultrasound to measure
endometrium
• Pelvic ultrasound
• Endometrial biopsy to check intrauterine
pathology
• D&C for diagnostic evaluation
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8. Dysfunctional Uterine Bleeding: Assessment
Treatment of dysfunctional uterine bleeding will vary
depending on the cause and may include:
 Medical care with pharmacotherapy:
 estrogen: cause vasospasm of the uterine arteries to decrease
bleeding
 Cyclic progesterone or long acting progesterone
 Oral contraceptives: regulate the cycle and suppress the
endometrium
 NSAIDs inhibit prostaglandin
 Iron replacement
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9. Dysfunctional Uterine Bleeding: Treatment
If the patient do not respond to medical intervention:
 D&C
 Endometrial ablation: is an alternative to
hysterectomy
 Thermal balloon to ablate the endometrium
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10. Dysfunctional Uterine Bleeding: Nursing
Management
The Nurse will:
 Educate the client about normal menstrual cycle and the possible
causes for her abnormal pattern
 Inform the woman about treatment option
 Inform her about any prescribed medication
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11. Dysfunctional Uterine Bleeding: Nursing
Management
If left untreated, dysfunctional uterine bleeding may result
in:
 infertility from lack of ovulation
 anemia from prolonged bleeding
 endometrial cancer from prolonged build up of the
endometrial lining without menstrual bleeding
Therefore follow up and evaluation is necessary
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12. Copyright 2013, State of Tasmania. This resource has been developed by
TasTAFE Health Services North. All content in this resource has been
produced by TasTAFE personnel and is made available to you for your
personal research and study. The content in this resource must not be redistributed or copied in any form.
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