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Complaints of excessive menstrual bleeding (menorrhagia) have a substantial impact on gynaecological services and in most cases no organic pathology is identified. Up to 50% of women who present with menorrhagia have blood losses within the normal range. Medical therapy is indicated for patients...
Dysfunctional uterine bleeding in adolescence is usually not a pathological process but a physiological adjustment in the achievement of normal reproductive status. The source of the problem in the vast majority of patients lies in the development of an intact hypothalamo–pituitary ovarian axis...
Uterine leiomyomas, or fibroids, are a major cause of abnormal uterine bleeding in women. These benign tumours develop during the reproductive years and their growth has been shown to be dependent on the ovarian steroid hormones oestradiol and progesterone. The growth promoting effects of these...
Hysterectomy is one of the commonest major operations, with 72 362 procedures performed in England in 1993. However, for women with dysfunctional uterine bleeding other less invasive surgical options have been developed. In particular, hysteroscopic endometrial ablation has been shown to be an...
Objective menorrhagia (measured menstrual blood loss of >80 ml) affects approximately 10% of the population, while the subjective complaint of menorrhagia is experienced by almost a third of the female population of childbearing age. Consequently, large numbers of women consult their general...
The surgical treatment of patients with dysfunctional uterine bleeding (DUB) is discussed in this chapter, including indications, techniques and complications. Hysterectomy is the definitive treatment for DUB; in most studies it has a higher rate of patient satisfaction than does hysteroscopic...
Menstruation is the process whereby the superficial or functionalis layer of the endometrium lining the uterine cavity disintegrates and is removed from the uterine lumen towards the end of the luteal phase of a non-pregnant cycle. Within a period of 5–6 days the old lining is removed and a new...
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