Symptom Finder - Dysfunctional Uterine Bleeding
Dysfunctional Uterine Bleeding (In women of childbearing age)
1. Thorough pelvic examination and Pap smear to rule out serious causes of vaginal bleeding. In patients where it is difficult to do a thorough pelvic (i.e., obese) get a sonogram. Remove IUD if one is present.
2. Pregnancy test to rule out pregnancy.
3. Medroxyprogesterone acetate (Depo-Provera): 150–250 mg IM to stop bleeding. It is the goal of therapy for regular periods (with normal menses) to be established once the exogenous hormones wear off.
4. Alternatively, especially if it is clear that the bleeding is cyclical, give 10–20 mg of Medroxyprogesterone (Provera) orally for the last week of each cycle to reduce bleeding during menses and re-establish a normal cycle.
5. If the above techniques are unsuccessful, look for anemia (especially iron-deficiency anemia), hypothyroidism or hyperthyroidism or refer the patient to a gynecologist for a D&C or other procedures (ultrasonogram, etc.).
1. Thorough pelvic examination and Pap smear to rule out serious causes of vaginal bleeding. In patients where it is difficult to do a thorough pelvic (i.e., obese) get a sonogram. Remove IUD if one is present.
2. Pregnancy test to rule out pregnancy.
3. Medroxyprogesterone acetate (Depo-Provera): 150–250 mg IM to stop bleeding. It is the goal of therapy for regular periods (with normal menses) to be established once the exogenous hormones wear off.
4. Alternatively, especially if it is clear that the bleeding is cyclical, give 10–20 mg of Medroxyprogesterone (Provera) orally for the last week of each cycle to reduce bleeding during menses and re-establish a normal cycle.
5. If the above techniques are unsuccessful, look for anemia (especially iron-deficiency anemia), hypothyroidism or hyperthyroidism or refer the patient to a gynecologist for a D&C or other procedures (ultrasonogram, etc.).
