DUB is the medical abbreviation for dysfunctional uterine bleeding, and it commonly occurs when there is a disbalance in sex hormones. If you’re curious about this condition, its types, causes, and possible treatment methods, this article is perfect for you. You’ll learn all of that and more in this expert article on dysfunctional uterine bleeding. We also elaborate on ovulatory DUB, operative hysteroscopy, and more. 

Before jumping straight in, make sure to seek out professional advice and guidance, especially if you or a loved one are dealing with dysfunctional uterine bleeding. We recommend OBGYN services in Boca Raton due to reliability, professional results, and friendliness.

That being said, what does DUB mean? What are the most common symptoms? Is operative hysteroscopy the only solution to DUB? Find out all of this and more below.

What Does DUB Mean?

As mentioned, the DUB medical abbreviation refers to dysfunctional uterine bleeding. This condition is sometimes called anovulatory bleeding; it’s vaginal bleeding that varies from a patient’s regular menstrual cycle. Signals from sex hormones trigger the woman’s normal menstrual cycle and cause abnormal bleeding. In a nutshell, DUB occurs when the hormonal signals of the menstrual cycle are thrown off. As a result, the woman experiences alternating menstrual periods that are light and heavy, unpredictable longer and shorter cycles, and spotting. 

Some medications and hormonal conditions can trigger the onset of DUB.

Always make sure you consult healthcare specialists for expert advice and proper diagnosis. For example, consulting specialists like Dr. David S Ellman are a good choice.

So, what does DUB mean? As the name suggests, it refers to abnormal uterine bleeding outside of a female patient’s regular menstrual cycle.

Types of Dysfunctional Uterine Bleeding

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The DUB medical abbreviation refers to two types of dysfunctional uterine bleeding: Anovulatory DUB and ovulatory DUB. We discuss each of these in detail below.

Approximately 90% of dysfunctional uterine bleeding happens when a woman is not ovulating. Anovulatory periods are frequent during reproductive age (including perimenopause and early puberty). Sometimes, a woman’s body is not adequately developed and unable to release a mature egg. As a result, the mound of tissue that creates progesterone (the corpus luteum) doesn’t form, and the body produces estrogen continuously. This, in turn, results in uterus lining overgrowth. 

In some cases, anovulatory dysfunctional uterine bleeding happens because of a delay in the complete maturation of a teenager’s reproductive system. That being said, the mechanisms remain unknown. Nevertheless, the etiology includes exercise, psychological stress, weight (rapid change, anorexia, obesity), neoplasm, endocrinopathy, and narcotics.

When assessing anovulatory DUB, the doctor will begin with a physical examination and analyze the patient’s medical history. Moreover, you will require laboratory assessment of follicle-stimulating hormone (FSH), hemoglobin, prolactin, luteinizing hormone (LH), thyroid-stimulating hormone (TSH), T4, androgen profile, and pregnancy. 

Ovulatory DUB, on the other hand, happens during ovulation. About 10% of dysfunctional uterine bleeding cases occur in women who are ovulating, but progesterone secretion is prolonged due to low estrogen levels.

Based on some evidence, ovulatory DUB may be linked with fragile blood vessels in the patient’s uterus. This can show a possible endocrine dysfunction, leading to metrorrhagia or menorrhagia. 

To understand one and the other DUB medical abbreviation, it’s helpful to look at normal menstrual physiology. A normal menstrual cycle has a proliferative and secretory phase. During the first stage, the body will have more estrogen than progesterone. Whereas the second stage begins when ovulation induces the production of progesterone. A woman will experience menstrual bleeding after estrogen and progesterone secretion tapers off. 

A normal menstrual cycle lasts around 28 days and lasts about four days.

Causes of Abnormal Uterine Bleeding

There are several known causes for abnormal uterine bleeding. These include:

Reproductive tract abnormalities:

  • Endometriosis
  • Fibroids
  • Adenomyosis
  • Benign pelvic lesions
  • Polyps, endometrial and cervical
  • Infections
  • Trauma (such as post-coital injuries)
  • Malignancy (cancer of the vagina, cervix, uterus, ovaries)

Pregnancy-related complications:

  • Molar pregnancy
  • Ectopic pregnancy
  • Spontaneous abortion (missed, incomplete, threatened)
  • Placental polyp

Factors related to medical procedures or medicines:

  • Contraceptives
  • Oral contraceptives
  • Intrauterine devices
  • Anticoagulation therapy
  • Levonorgestrel implant
  • Medroxyprogesterone contraceptive injection
  • Certain psychiatric drugs
  • Hormone replacement therapy

Systematic diseases:

  • Hypothyroidism
  • Coagulation disorder
  • Cirrhosis or liver failure

On top of this, sexually transmitted diseases or STDs can cause dysfunctional uterine bleeding. Because STDs can cause inflammation (such as chlamydia and gonorrhea), you may experience DUB. Bleeding as a result of an STD usually happens after sexual intercourse.

Symptoms of Dysfunctional Uterine Bleeding

The most common DUB symptom is bleeding outside of a regular menstrual period. However, women may experience DUB within a period. Look for the following symptoms to check if you have dysfunctional uterine bleeding:

  • Spotting
  • Bleeding later than 35 days from your last period
  • Bleeding less than 21 days from your last period
  • Bleeding that lasts more than a week
  • Heavy menstrual bleeding
  • You notice many large clots
  • Bleeding between your regular menstrual periods

You may also experience pelvic pressure, pain, or bloating due to dysfunctional uterine bleeding. In case you also notice some of the following symptoms, immediately consult a healthcare expert:

  • Pain
  • Pale skin
  • Increased heart rate
  • Low blood pressure
  • Fainting
  • Weakness
  • Dizziness
  • Positive pregnancy test and bleeding
  • Soaking a pad every hour

Proper DUB Diagnosis

As you already know, to diagnose dysfunctional uterine bleeding, your healthcare provider will ask about your medical history and your menstrual cycle. By answering these questions, your doctor will gain insight into your overall reproductive health and whether you’re at risk of certain disorders such as endometriosis or PCOS. In addition, always tell your doctor if you are taking medications such as birth control.

Firstly, your healthcare provider may suggest an ultrasound to analyze the reproductive organs. This way, you will know if you have abnormal growths such as fibroids or polyps. Next, you’ll need blood tests to measure complete blood count and hormone levels. Hormone levels are an excellent way to see the cause of the bleeding. For instance, patients with a low red blood cell count may have anemia.

Operative hysteroscopy is a procedure to locate and treat issues with the uterus. Before operative hysteroscopy, you will receive medicine for relaxation or for sleep. The procedure is painless.

If the bleeding happens due to abnormal growth or if the uterine lining is too thick, the healthcare provider may want to check the uterine tissue. A biopsy will quickly reveal if there are any abnormal cell changes in your uterine lining. Abnormal cells can point to cancer or hormonal imbalances.

Treating Dysfunctional Uterine Bleeding


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If you received a DUB diagnosis, worry not; there are many possible treatment methods for you. If the condition happens during puberty, you don’t have to do anything, as the hormones tend to regulate on their own. However, you will need to know the underlying cause of bleeding to receive the proper treatment. 

One of the simplest ways to treat DUB is with oral contraceptives containing synthetic progesterone and estrogen. Both these hormones regulate and control your menstrual cycle. 

Other contraceptive methods include the progestin implant and progestin IUDs. Alternatively, if the bleeding is heavy and low-dose medications aren’t a good fit, you may receive intravenous estrogen until your condition gets better. 

These treatment methods are ideal for people who are not planning to conceive. 

On the other hand, patients who want to conceive and don’t have extreme bleeding may choose clomiphene, an ovulation-stimulating drug (or Clomid). By stimulating ovulation, prolonged menstrual bleeding stops.

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Dr. Ellman is a Board Certified OBGYN who established his medical practice in South Florida over 25 years ago. His office, Women’s Healthcare of Boca Raton, is located in Boca Raton, Florida at West Boca Medical Center. Dr. Ellman attended Albert Einstein College of Medicine of Yeshiva University, where he received his medical degree. He went on to intern at Beth Israel Hospital in Boston- an affiliate of Harvard Medical School- and continued his residency at North Shore University Hospital in Manhasset, New York- an affiliate of Cornell Medical School.

Dr. Ellman has practiced Obstetrics and Gynecology in the Boca Raton area since 1995. In addition to treating patients at West Boca Hospital, Dr. Ellman also treats patients through his own private practice, Women’s Healthcare of Boca Raton, located on the West Boca Medical Campus.

Published On: March 7th, 2022