Abnormal Uterine Bleeding Causes

Aka: Abnormal Uterine Bleeding Causes

1. See Also
   1. Menstrual Cycle
   2. Abnormal Uterine Bleeding (Dysfunctional Uterine Bleeding)
   3. Anovulatory Bleeding (Metrorrhagia)
   4. Ovulatory Bleeding (Menorrhagia)
   5. Uterine Bleeding in Pregnancy
   6. First Trimester Bleeding
   7. Late Pregnancy Bleeding
   8. Endometrial Cancer Screening
   9. Oral Contraceptive-Related Uterine Bleeding Management
   10. Postmenopausal Bleeding
   11. Amenorrhea
   12. Lower GI Bleed
   13. Hematuria
2. Causes: Age-Specific uterine bleeding Causes
   1. Prepubertal Years (before Menarche)
      1. Newborn girls
         1. Placental Estrogen withdrawal bleeding
      2. Accidental trauma
      3. Vaginitis secondary to foreign body
      4. Prolapse of Urethral meatus
      5. Sexual abuse
      6. Ingestion of Estrogen containing products
      7. Malignancy
   2. Early Reproductive Years
      1. Anovulatory cycles with Menarche (initially 55-85%)
      2. Primary coagulation disorders (19%)
      3. Pregnancy related disorders
   3. Later reproductive and postmenopausal years (age >35)
      1. See Menopause
      2. Evaluate for Malignancy!
      3. Postmenopausal Endometrial Hyperplasia
         1. If no Estrogen Replacement, find Estrogen source
3. Causes: Coagulation Bleeding Disorders (common)
   1. See Coagulopathy in Pregnancy
   2. See Coagulation Bleeding Disorders
   3. See Platelet Dysfunction
   4. Von Willebrand's Disease (most common)
   5. Thrombocytopenia
      1. Aplastic Anemia
      2. Idiopathic Thrombocytopenic Purpura
      3. Systemic Lupus Erythematosus (SLE)
      4. Sepsis
   6. Glanzmann's Disease
   7. Fanconi's Anemia
   8. Thalassemia major
   9. Acute Leukemia
   10. Acute Liver Disease
   11. Renal Disease
4. Causes: Pregnancy-related uterine bleeding complications
   1. See Uterine Bleeding in Pregnancy
5. Causes: Endocrine-related uterine bleeding complications
   1. Thyroid
      1. Hyperthyroidism
      2. Increased Sex Hormone Binding Globulin
         1. Increased Testosterone
         2. Polycystic Ovary Syndrome
      3. Hypothyroidism
         1. Increased Prolactin
   2. Adrenal
      1. Addison's Disease
      2. Cushing's Syndrome
      3. Excessive Androgen Production
   3. Miscellaneous
      1. Prolactinoma
      2. Polycystic Ovary Syndrome
6. Causes: Medication-related Uterine Bleeding Disorders
   1. See Medication Causes of Abnormal Uterine Bleeding
7. Causes: Structural-related uterine Bleeding Disorders
   1. Local infection
      1. Cervicitis
      2. Endometritis
      3. Salpingitis
   2. Adenomyosis Cervicitis
   3. Endometrial and Endocervical Polyps
   4. Endometrial Hyperplasia
   5. Endometrial Cancer
   6. Ovarian Cancer
   7. Functional ovarian tumors (produce sex hormones)
   8. Cervical Dysplasia
   9. Cervical Cancer
   10. Submucosal or intramural leiomyoma
   11. Uterine Fibroids
   12. Sarcoidosis
   13. Tuberculosis of the endometrium
   14. Vaginal trauma (foreign body, sexual abuse, Laceration)