Abnormal Uterine Bleeding
Abnormal uterine bleeding (AUB) is the primary reason for one-third of all gynecology visits and more than half of all hysterectomies. After excluding pregnancy, the basic evaluation consists of a thorough history and physical examination, anatomic assessment by ultrasound, laboratory evaluation, and, often, endometrial biopsy. Irregular cycles are commonly due to anovulation resulting from polycystic ovary syndrome, but other causes and coexisting conditions must be excluded. Medical management will significantly improve or resolve symptoms in many women and can include hormonal therapy, nonsteroidal antiinflammatory drugs, or tranexamic acid. When AUB does not respond to standard hormonal therapies, antibiotic treatment of subclinical endometritis can be considered. Surgical approaches remain important options for both evaluation and treatment of AUB.
