Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the vagina that is not due to a physical (anatomical) cause.

DUB may be caused by an imbalance of hormones -- estrogen or progesterone.

Risk factors include:

• Emotional stress
• Excessive exercise
• Obesity

DUB occurs in women during their reproductive years (they have started their period but have not reached menopause). About 20% of DUB cases occur in adolescents and 40% occur in women over 40.

• Abnormal menstrual periods
• Bleeding from the vagina between periods
• Changing menstrual cycles (usually less than 28 days between menstrual periods)
• Changing menstrual flow ranging from very little to a lot
• Excessive growth of body hair in a male pattern (hirsutism)
• Hot flashes
• Infertility
• Mood swings
• Tenderness of the vagina

Dysfunctional uterine bleeding (DUB) is diagnosed after all other causes of abnormal uterine bleeding are ruled out. This includes:

• Disease
• Early pregnancy disorders
• Infection
• Structure problems
• Tumors

The health care provider will do a pelvic examination.

Tests usually include:

• CBC
• Blood clotting profile
• Hormone tests
  • FSH
  • LH
  • Male hormone (androgen) levels
  • Prolactin
  • Progesterone
• Serum HCG (to rule out pregnancy)
• Thyroid function tests

The following procedures may be done:

• D and C
• Endometrial biopsy
• Hysteroscopy
• Pelvic ultrasound