title: Management of Abnormal Uterine Bleeding with Emphasis on Alternatives to Hysterectomy.
abstract: Abnormal uterine bleeding (AUB) is a common problem that negatively impacts a woman's health-related quality of life and activity. Initial medical treatment includes hormonal and nonhormonal medications. If bleeding persists and no structural abnormalities are present, a repeat trial of medical therapy, a levonorgestrel intrauterine system, or an endometrial ablation can be used dependent on future fertility wishes. The levonorgestrel intrauterine system and endometrial ablation are effective, less invasive, and safe alternatives to a hysterectomy in women with AUB. A hysterectomy is the definitive treatment of AUB irrespective of the suspected cause when alternative treatments fail. Future studies should focus on detection of predictors for treatment outcomes.
authors: Department of Obstetrics and Gynecology and Reproductive Biology, University Hospitals, Case Medical Center, Cleveland, OH, USA; Department of Reproductive Biology, University Hospitals, Case Medical Center, Cleveland, OH, USA.
authors: Megan R
authors: MR
authors: Billow
authors: Department of Obstetrics and Gynecology and Reproductive Biology, University Hospitals, Case Medical Center, Cleveland, OH, USA; Department of Reproductive Biology, University Hospitals, Case Medical Center, Cleveland, OH, USA; Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt. Electronic address: sherif.el-nashar@uhhospitals.org.
authors: Sherif A
authors: SA
authors: El-Nashar
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D000075202:Contraindications; D055356:Endometrial Ablation Techniques / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D014481:United States; D014592:Uterine Hemorrhage / Q000628:therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: Abnormal uterine bleeding; Endometrial ablation; Heavy menstrual bleeding; IUD; Medical management