Abnormal Uterine Bleeding

1. List etiologies of dysfunctional uterine bleeding which are non-functional (i.e., secondary to an organic cause) including pregnancy-related causes, benign conditions and genital tract malignancies.

2. Discuss the hormonal causes of dysfunctional uterine bleeding.

3. Outline a differential diagnosis of dysfunctional uterine bleeding according to age; child, pubertal, adult, perimenopausal and postmenopausal.

4. Outline the necessary steps in the evaluation of a woman with postmenopausal bleeding before beginning medical management..

5. Describe health risks associated with continuous unopposed estrogen therapy in the woman with an intact uterus.

6. Describe at least one hormonal regimen used to stop menorrhagia.

7. Discuss methods of preventing recurrences of dysfunctional uterine bleeding with respect to the woman's current reproductive goal (menstrual regulation, contraception or pregnancy).

8. List the causes for abnormal uterine bleeding during pregnancy.

9. List the post-partum causes of abnormal uterine bleeding.

10. Discuss the evaluation, cause and treatment modalities a family physician could manage without referral.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 63, Pages 387-391

Reading Resources:

"Abnormal Uterine Bleeding"  Kathleen A. Oriel, M.D. and Sarina Schrager, M.D., University of Wisconsin School of Medicine, Madison, WI, American Family Physician, October 1, 1999.

"Premenstrual Syndrome" Lori M. Dickerson, Pharm.D. et al., Medical University of South Carolina, Charleston, SC, American Family Physician, April 15, 2003.