Treatment options for dysfunctional uterine bleeding: evaluation of clinical results

摘要

Abnormal uterine bleeding is one of the most common problems in women of reproductive age, and dysfunctional uterine bleeding (DUB) accounts for about half the cases. The aim of this review is to present all treatment options for women suffering from DUB and to evaluate their effectiveness. A detailed search strategy on electronic databases was carried out to identify trials and reviews on management of abnormal uterine bleeding. Tranexamic acid is the most effective medical treatment. A levonorgestrel-releasing intrauterine device is a low-cost, simple, and effective medical method, comparable to hysterectomy in terms of quality of life. In cases of DUB resistant to medical treatment, surgical treatment should be offered. First-generation ablation techniques are effective, but have a long learning curve. Second-generation ablation devices are highly effective and safe alternatives, thoroughly compared to first-generation techniques. Hysterectomy is the only method that guarantees treatment of dysfunctional uterine bleeding, but is a major operation associated with higher morbidity and mortality rates. Proper counseling of each woman with DUB regarding all treatment modalities can provide the best choice for each patient. More prospective randomized trials are needed to establish the effectiveness of these methods