Abnormal Uterine Bleeding During The Reproductive Years

Abnormal Uterine Bleeding During The Reproductive Years

Fahimeh Ramezani Tehrani

Professor

  Reproductive Endocrinology Research Center

Research Institute for Endocrine Sciences

Shahid Beheshti University of Medical Sciences

Regular menstrual cycles; the main component of “female sensuality”

Prevalence

• Most common problem for gynecologic consultation(>20%) (Obstet Gynecol 2001)

• 12% women overall, 24% women aged 36-40 y, up to 50% of perimenopausal women  (J Clin Epidemiology 2005)

50. 25% of gynecologic surgeries is related to AUB

• >50% hysterectomies performed
• Iron deficiency anemia develops in 21-67% of cases (Annal Hematol 1997)
• 40-80% of women treated for AUB have no anatomical pathology (Cochrane Database Syst Rev 2008)
• 53% of women used medical treatment had undergone surgery during follow up (Olave 2007)
• Significant decrease in overall quality of life, HRQoL of women with AUB is less than 25^th percentile of national norm

     (Value health 2007)

• Sexual function score of  women with AUB is 55-69 as compared to 100(optimal functioning) (Value health 2007)

Health services utilization & costs

• AUB contributed to
  • more than 5 million hospitalizations
  • 2 million hysterectomies
  • 20 million hospital days
  • Total direct cost $1 billion annually
  • Total indirect cost $12 billion
  • Work loss from increased blood flow $1692 annually per women
  • Heavy bleeders worked 3.6 weeks fewer than non heavy bleeders

(Health Econ 2011)