Abnormal uterine bleeding (clinical lecture)

Abnormal uterine bleeding (AUB) not related to pregnancy has been one of the leading reasons for visiting a gynecologist for many years. The incidence of AUB is approximately 30% among patients of reproductive age and can increase to 70% during the perimenopausal period. Recurrent AUB leads to the development of iron deficiency anemia, significantly reducing the quality of life, and also resulting in additional costs for hygiene products.

This clinical lecture provides a modern classification of AUB. It focuses on the main mechanisms of development of this pathology in adolescence and reproductive age. The causes of AUB are analyzed, and the classification, symptomatology, and clinical presentation of the studied conditions are presented. The lecture covers international criteria for pathologic uterine bleeding, clinical criteria for assessing bleeding severity according to Mansfield–Vode–Jorgensen scale and estimation of blood loss volume according to Algover index. Detailed consideration is given to the issues of differential diagnosis, general principles of therapy, and indications for traditional, hormonal, and surgical hemostasis. The lecture also outlines the algorithm of diagnostic search for patients in the adolescent, reproductive, postmenopausal age groups, as well as for patients on the background of menopausal hormonal therapy.