A study of the efficacy of medical management of AUB in Perimenopausal women

Abstract

Background: Abnormal Uterine Bleeding (AUB) is caused by either Organic lesions such as genital tract infections, tumors, adenomyosis, pregnancy and its complications, systemic disorders or Dysfunctional Uterine Bleeding (DUB). In women ≥ 40 years, and certainly in menopausal patients, it mandates evaluation to confirm benign nature of the problem, by ruling out endometrial carcinoma, so that medical treatment or conservative surgery can be offered and unnecessary radical surgery can be avoided. Aim: Categorizing of Perimenopausal women with AUB for further management according to histo-pathological report and to study the efficacy of medical management. Material and Methods: A total of 60 patients were selected who presented with symptoms of abnormal uterine bleeding at perimenopausal age group (40-54 years). Histopathological results were evaluated after obtaining endometrial tissue and patients are treated accordingly. Treatment response was assessed and tabulated. Statistical Analysis has done by danielsoper.com using chi-square test. Results: Abnormal uterine bleeding was mostly seen in multiparous women with parity >2 about 63.3%. Among menstural irregularities, 45% of cases presented with menorrhagia. Most of the patients were diagnosed as Anovulatory DUB about 60%. Out of 11 hyperplasia patients, 2 (18.1%) patients diagnosed as complex hyperplasia without atypia. No progression of AUB has seen after MPA treatment among all patients with endometrial hyperplasia. Conclusion: Cyclical oral progestogens are effective in regulating and reducing irregular bleeding due to Oligo/Anovulation. Majority of the cases of endometrial hyperplasia without atypia can be successfully treated with progestogen therapy.