Volume 04 Issue 10-2024
85
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
85-90
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Abnormal uterine bleeding (AUB) is a common gynecological problem affecting women at different stages of life:
from adolescence to menopause. This article discusses statistical data and the main causes leading to AUB in different
age groups. Attention is drawn to the characteristic features of menstrual disorders in adolescents, women of
reproductive age and during menopause, and modern treatment, including both conservative and surgical methods,
is presented. Research shows that adequate diagnostics and an individualized approach to treatment can significantly
improve the quality of life of patients and prevent serious complications. The article emphasizes the importance of
early medical care and regular gynecological examinations to ensure women's health at all stages of their lives.
KEYWORDS
Abnormal uterine bleeding (AUB), complications, treatment, conservative methods, surgical methods, adolescence,
reproductive age, menopause.
INTRODUCTION
Abnormal uterine bleeding (AUB) is a common
gynecological disorder that can occur at any age and
has a significant impact on women's quality of life. AUB
is defined as any deviation from the normal menstrual
cycle, including heavy, prolonged, or irregular
menstruation. The problem of AUB is multifaceted,
requiring a careful approach to diagnosis and
treatment depending on different stages of a woman's
Research Article
ABNORMAL UTERINE BLEEDING AT DIFFERENT PERIODS OF A
WOMAN'S LIFE
Submission Date:
October 15, 2024,
Accepted Date:
October 20, 2024,
Published Date:
October 25, 2024
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume04Issue10-14
Karimova Gulchekhra Samadovna
Assistant Samarkand State Medical University, Samarkand, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 10-2024
86
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
85-90
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
life, such as adolescence, reproductive age, and
menopause. According to statistics for the last five
years, AUB occurs in up to 30% of reproductive age
women and 42% in premenopausal. The causes of AUB
can vary from hormonal imbalance to serious
pathologies such as fibroids or malignant neoplasms.
The results of studies on conservative and surgical
methods of treating abnormal uterine bleeding (AUB)
demonstrate
the
effectiveness
of
different
approaches, depending on specific clinical situations
and causes of bleeding.
The purpose of this article is to review the main age-
related features of AUB, conservative and surgical
methods of treatment of AUB at different ages, as well
as their indications and efficacy
Adolescence
According to research, about 30% of adolescent girls
experience AUB. The first menstruation (menarche)
can often be irregular and accompanied by heavy
discharge. About 15-30% of girls have symptoms such as
dysmenorrhea, which makes their quality of life less
comfortable (Akkuzu et al., 2020).
Causes and treatment
The most common causes of AUB in adolescence are
hormonal disorders, stress, eating disorders, and
inadequate physical activity. At this age, treatment
includes conservative methods, such as:
1. Hormonal therapy: combined oral contraceptives will
help normalize the menstrual cycle. Hormonal agents:
used to regulate the menstrual cycle and reduce the
amount of bleeding. For example, combined oral
contraceptives (COCs) can be effective in stabilizing
hormonal levels and regulating menstruation. A 2020
study found that the use of combined oral
contraceptives (COCs) in women with AUB changed
the nature of menstruation, helping to reduce the
amount of bleeding by 50-70%. The effectiveness of
maintaining a normal menstrual cycle increases
significantly with long-term therapy (Davydov, 2020).
Progestogens can also be used to treat abnormal
bleeding due to progesterone deficiency. More than
80% of women who received progestogens noted an
improvement in their condition, including a decrease in
the amount of menstruation and relief of premenstrual
syndrome (Petrenko, 2021).
2. Some NSAIDs: can be prescribed to reduce pain
symptoms and the amount of blood loss. Data on the
nature of menstruation in adolescence emphasize the
need for medical supervision by a gynecologist to
prevent possible serious diseases later (Astin et al.,
2019). Drugs such as ibuprofen can help reduce the
amount and duration of bleeding due to their anti-
inflammatory and analgesic properties. According to a
study published in 2019, the use of NSAIDs such as
ibuprofen resulted in a 30-40% reduction in menstrual
flow in women with dysmenorrhea and AUB and also
Volume 04 Issue 10-2024
87
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
85-90
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
reduced the associated pain symptoms (Sidorova,
2019).
Reproductive age
During the reproductive period, the prevalence of AUB
increases and reaches 35-50% among women aged 20-
40 years. The most common pathologies leading to
AUB
include
uterine
fibroids,
polyps,
and
endometriosis (Boulanger et al., 2021).
Causes and treatment
At this age, AUB can be caused by:
1. Ovulatory dysfunction - a violation of the regularity
of ovulation, which is often associated with stress or
changes in hormonal levels.
2. Anatomical disorders - such as fibroids and polyps.
Treatment may include:
• Hormonal therapy: the use of progestogens and
COCs to regulate cycles.
Gonadotropin-releasing hormone (GnRH) agonists:
These drugs can be used for short-term treatment of
myomas, reducing tumour size and bleeding
(Petrenko, 2021). Antifibrinolytic drugs: For example,
tranexamic acid can help reduce blood loss, especially
in heavy menstruation. Tranexamic acid has
demonstrated a 50% reduction in blood loss compared
to placebo. This is particularly noticeable in heavy
menstruation, indicating that it is highly effective
(Mihaylova, 2021).
• Surgical methods: hysteroscopy to remove polyps
and fibroids, as well as curettage.
Studies show that surgical intervention in women of
reproductive age can lead to complete resolution of
symptoms in 60-80% of patients (Katz & Stotland,
2020).
Climax
During menopause (age 45-55), about 50% of women
experience AUB, and this problem requires special
attention. At this stage, changes in hormonal levels
lead to unstable menstrual cycles and, as a result,
heavy or irregular bleeding (Pal et al., 2019).
Causes and treatment. During menopause, AUB can be
caused by:
1. Hormonal changes - in particular, lack of estrogen.
2. Anatomical changes - such as endometrial
hyperplasia.
Treatment at this stage may include:
• Hormone replacement therapy: to manage
menopausal symptoms and normalize the menstrual
cycle.
• Surgical methods: if there are significant changes in
the endometrium (hysterectomy).
Volume 04 Issue 10-2024
88
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
85-90
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
According to statistics, 30-50% of women over 50 who
have undergone a hysterectomy report a complete
restoration of their quality of life (Keeney et al., 2021).
Surgical Treatments
Surgical treatment of AUB is indicated in cases where
conservative measures are ineffective, or in the
presence of pathology requiring surgical intervention.
Hysteroscopy allows not only to diagnose, but also to
treat pathologies that cause AUB. During the
procedure, polyps, fibroids, or other abnormalities that
contribute to bleeding can be removed. This technique
has a minimal number of complications and allows
patients to recover quickly. In a study conducted in
2020, 90% of women who underwent hysteroscopy
reported a significant reduction in bleeding and
improved quality of life within 6 months after the
procedure. This technique showed a low complication
rate and rapid rehabilitation (Gavrilova, 2020).
Endometrial curettage may be indicated for the
diagnosis and treatment of AUB, especially if atypical
changes in the endometrial tissue are suspected. This
method allows for the removal of excess tissue, which
can lead to reduced bleeding. A 2019 study found that
endometrial curettage resulted in a reduction in the
duration and volume of menstruation in 75% of
patients, while 10% experienced a recurrence of clinical
symptoms (Zaretskaya, 2019).
Surgical removal of fibroids and polyps is also a
common method, especially if they are the cause of
heavy and prolonged bleeding. Surgeries can be
performed both openly and laparoscopically, which
provides less trauma to the tissue. Laparoscopic
methods of fibroid removal have shown effectiveness
in 85-90% of cases, with most women reporting
significant improvement after surgery (Kuznetsova,
2021).
Hysterectomy (removal of the uterus) is considered
the last step when other treatments have failed or
there are serious pathologies such as cancer. This
method remains the most radical, but it is also the most
effective in eliminating the source of the problem.
Hysterectomy, as a radical method, has demonstrated
more than 95% effectiveness in eliminating abnormal
uterine bleeding in women with severe symptoms or
concomitant pathologies such as fibroids or cancer
(Saveleva, 2022).
CONCLUSION
Abnormal uterine bleeding is a common problem that
requires careful attention at all stages of a woman’s
life. The treatment approach should be individualized
and take into account age-related changes, hormonal
levels, and associated diseases. Early consultation with
a doctor and regular medical examinations will help
avoid serious consequences associated with AUB.
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International Journal of Medical Sciences And Clinical Research
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VOLUME
04
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P
AGES
:
85-90
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
Treatment of abnormal uterine bleeding should be
individualized and based on the patient's overall
health, causes of bleeding, and desired results.
Conservative methods can be very effective, but in
some cases, surgical interventions are necessary. Early
consultation with a doctor and a comprehensive
approach to treatment will help prevent the
development of severe forms of the disease. Research
results show that both conservative and surgical
methods have their own characteristics and
effectiveness in the treatment of AUB. Conservative
methods can be very effective in mild to moderate
manifestations, while surgical methods are often
required in more complex cases. The correct choice of
treatment approach is based on the individual
characteristics of the patient and the clinical situation.
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