Patient's question:
I had my period on April 28th, and on the night of May 2nd, I suddenly experienced heavy bleeding with large blood clots. The bleeding was excessive, and I first received a progesterone shot to stop it. Then, I went to the hospital for an ultrasound, which revealed that my uterus was enlarged with blood clots, but everything else was normal. The doctor diagnosed it as dysfunctional uterine bleeding (DUB) and suggested a D&C (dilation and curettage). However, after the progesterone shot, the blood clots reduced, and the bleeding lessened. Do I still need to have a D&C? Is there no other treatment option besides a D&C? It's May 3rd now, and I'm currently considering whether to have a D&C or try other methods to stop the bleeding. I haven't given birth yet, and I'm worried that the D&C might affect my fertility. I received a progesterone shot yesterday, and the bleeding has already stopped.Doctor's answer:
Functional uterine bleeding is a term used in modern medicine, referring to uterine bleeding caused by dysfunction of the ovarian function, commonly abbreviated as "Dysfunctional Uterine Bleeding" (DUB). This condition is divided into two types: anovulatory DUB and ovulatory DUB. The former occurs when ovulation function is impaired, often seen in adolescents and postmenopausal women; the latter is due to luteal dysfunction, more common in women of reproductive age. The etiology is multifactorial, including systemic factors, hypothalamic-pituitary-ovarian axis dysfunction, uterine and endometrial factors, and other factors, etc. It is characterized by menstrual cycle irregularity and changes in the quantity and nature of uterine bleeding. The main symptoms include: oligomenorrhea (infrequent menstruation), polymenorrhea (frequent menstruation), menorrhagia (excessive menstrual bleeding), hypomenorrhea (light menstrual bleeding), menstrual irregularity, irregular menorrhagia, and mid-cycle bleeding, etc. The treatment of DUB depends on the patient's age, type of DUB, endometrial pathology, and fertility requirements to determine the principles, methods, medications, and monitoring.