Dysfunctional Uterine Bleeding (DUB)
Dr Jenny Cook | Sydney Gynaecologist & Advanced Laparoscopic Surgeon
Understanding and Managing Abnormal Bleeding
Dysfunctional Uterine Bleeding (DUB) refers to any irregular or heavy bleeding. It may be related to hormonal changes such as PCOS or perimenopause, and many women notice changes to their bleeding patterns in their early 40s.
While this can feel disruptive, there are effective ways to investigate and manage the condition.
Causes and Management of DUB
Exploring causes, investigations, and treatment options for abnormal bleeding.
1. Causes of DUB
- Hormonal changes – PCOS or changes around menopause.
- Endometrial polyps or submucosal fibroids – can cause heavy, irregular bleeding.
- Intramuscular fibroids – often associated with heavy menstrual bleeding.
- Adenomyosis – when the uterine lining (endometrium) grows into the muscle of the uterus, making it enlarged and inflamed. This is strongly linked with endometriosis and is the most common benign cause of heavy, painful periods for women in their 40s.
2. Investigations
In order to identify the cause of abnormal bleeding, I may recommend:
- Pelvic ultrasound – to assess the uterus, measure the lining thickness, and check for fibroids or polyps.
- Hysteroscopy – a direct look inside the uterus, often combined with an endometrial biopsy for closer examination.
- Polyp or fibroid removal – are removed during hysteroscopy if these are identified.
3. Treatment Options
Treatment depends on the underlying cause and severity of bleeding. Options may include:
- Hormonal treatments – a Mirena IUCD is highly effective at controlling heavy, irregular bleeding.
- Non-hormonal treatments – such as Tranexamic Acid tablets, which can reduce blood loss during periods.
- Surgery – for women with extremely heavy bleeding, a Total Laparoscopic Hysterectomy may be recommended. (This is discussed in more detail in the Surgery section of this site.)
Together, we will review the options and decide on a management plan that aligns with your circumstances and preferences.
Case Studies
Find relief from heavy or irregular bleeding.
With the right investigations and tailored treatment, abnormal bleeding can be effectively managed. I am here to provide clear guidance and support every step of the way.