Disfunctional Uterine Bleeding(DUB)

Causes: 

• 1)PCOS
• 2)Endometriosis. 
• 3(Uterine polyps. 
• 4)Uterine fibroids. 
• 5)Sexually transmitted diseases (STDs). 

Clinical Features:

• 1) uterine bleeding 
• 2) features of anaemia (fatigue, weakness, tiredness, palpitation etc)

Investigations: 

• 1) USG of L/A 
• 2) FT4 & TSH 
• 3)CBC
• 4)Pap smear 
• 5)Liver function test 
• 6) endometrial smpling 
• 7) Coagulation profile 

🗒️Rx:

Bleeding is large amount 

1. Cap.Xamic(Tranexamic acid)(500mg)

• 1+1+1........3-5 days
  

2. Cap.Zif-CI (zinc+iron+folic acid)

• 1+0+1.... ..1 month

☑️May add:

Tab.Normens(norethisterone) (5 mg)

• 1+0+1.....21 days contineous 1st day menstration then  stop 7 days . Repeat this cycle for 3 month.(২১ দিন তারপর ৭ দিন বন্ধ। এভাবে....৩ মাস ( মাসিকের ১ম দিন থেকে শুরু করবেন)

☑️If pain: 

Tab.Naprox(naproxgen)(500mg)

• 1+0+1.....5 days

OR

Tab.Viset(Tiemonium)  (50mg)

• 1+1+1...5 days  (ভরা পেটে)

Tab.Nexum(Esomeprazol) (20mg)

• 1+0+1…. 7 days

Surgical options: 

• Endimetrial Ablation 
  
• Myimectomy or Uterine artery embolizatuon.
  
• Hysterectomy.
  

Advice:

• Maintain a healthy weight
  
• Take your birth control pills as directed and at the same time every day
  
• Take your hormone replacement therapy as directed and at the same time every month
  
• Take a stress management class, listen to soothing music or learn some relaxation exercises — step back and smell the roses