title: Emergency department management of vaginal bleeding in the nonpregnant patient.
abstract: Abnormal uterine bleeding is the most common reason women seek gynecologic care, and many of these women present to an emergency department for evaluation. It is essential that emergency clinicians have a thorough understanding of the underlying physiology of the menstrual cycle to appropriately manage a nonpregnant woman with abnormal bleeding. Evidence to guide the management of nonpregnant patients with abnormal bleeding is limited, and recommendations are based mostly on expert opinion. This issue reviews common causes of abnormal bleeding, including anovulatory, ovulatory, and structural causes in both stable and unstable patients. The approach to abnormal bleeding in the prepubertal girl is also discussed. Emergency clinicians are encouraged to initiate treatment to temporize an acute bleeding episode until timely follow-up with a gynecologist can be obtained.
authors.affiliation: Department of Emergency Medicine, Georgetown University School of Medicine, Washington, DC, USA.
authors.forename: Joelle
authors.initials: J
authors.lastname: Borhart
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D021721:Balloon Occlusion; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008487:Medical History Taking; D010808:Physical Examination; D011372:Progestins / Q000008:administration & dosage; D014592:Uterine Hemorrhage / Q000209:etiology / Q000517:prevention & control / Q000601:surgery / Q000628:therapy*
chemical_list: D000933:Antifibrinolytic Agents; D003278:Contraceptives, Oral, Hormonal; D011372:Progestins