ABNORMAL UTERINE BLEEDING and TREATMENTS

abnormal uterine bleeding-- alteration in the normal pattern or volume of blood flow of menses.Practically speaking, a change in duration of flow must be considered abnormal even if by definition she does not have menorrhagia
What is normal menstrual flow?
Normal Duration- 4-7 days, abnormally prolonged >7 days, too short is <2days, color="#cc33cc">PROGESTINS because it stops the endometrial growth, supports and organize the endometrium.It causes organized slough off up to the basalis layer,increases the PGE2alpha.Treatment of choice among adolescents until maturity is achieved
if medroxyprogesterone acetate , or Provera(MPA) is given- 10mg for 10 days per month
for anovulatory patients- give day 12 to 25 of cycle,
for ovulating patients, give it on day 5 to 25 of cycle
for premenopausal ,give conjugated estrogen 0.625 to 1.25 mg for 25 days and MPA 10mg day 15 to day 25 of cycle
PROGESTERONE -RELEASING IUD or Mirena can also be given

2.NSAIDS -if combined w/ other medications,it inhibits endoperoxides that convert arachidonic acid to prostaglandin on 1st 3 daYS of menses or throughout bleeding .Best is Ibuprofen 400mg q6hours

3.ANTIFIBRINOLYTIC AGENTS-combined w/ other agent

4.GNRH-agonists
5.DANAZOL-200mg to 400mg daily for 12 weeks

SURGICAL TREATMENTS:
1.Dilatation and Curettage- can also be just a diagnostic tool
2.Endometrial ablation
3.hysterectomy