WB01508   Dysfunctional Uterine Bleeding

Reading Materials:

Chapter 15, Dysfunctional Uterine Bleeding,

Clinical Gynecologic Endocrinology and Infertility, Speroff, et. al.,

Lippincott Williams and Wilkins, Philadelphia, 2005, pages 547-571

Objectives

1.       Differentiate between normal menstrual bleeding and

          dysfunctional uterine bleeding

2.       Describe physiologic and pharmacologic endometrial responses

          to steroid hormones

3.       Discuss anovulatory bleeding, its differential diagnoses

          and treatment

4.       Summarize the character, diagnosis and treatment for endometrial

          hyperplasia and neoplasia

5.       Explain other causes of abnormal vaginal bleeding, their etiology

          and treatment

6.       Review nonspecific treatments for abnormal menstrual bleeding

Content Outline

1.       Normal menstrual bleeding

          1.1     Characteristics

          1.2     Mechanisms of onset and cessation

2.       Endometrial Responses to Steroid Hormones

          2.1     Estrogen withdrawal and breakthrough bleeding

          2.2     Progesterone withdrawal and breakthrough bleeding

3.       Anovulatory Bleeding

          3.1     Definitions

          3.2     Differential diagnoses

          3.3     Diagnostic evaluation

          3.4     Treatment

4.       Endometrial Hyperplasia and Neoplasia

          4.1     Characteristics

          4.2     Treatment

5.       Abnormal Bleeding from Other Causes

          5.1     Chronic endometritis

          5.2     Uterine leiomyomas

          5.3     Endometrial polyps

          5.4     Adenomyosis

          5.5     Coagulation defects

6.       Nonspecific Treatments for Abnormal Menstrual Bleeding

          6.1     NSAIDS

          6.2     Oral contraceptives

          6.3     Levonorgestrel IUD

          6.4     GrRH agonists

          6.5     Endometrial ablation