Abnormal Uterine Bleeding in Reproductive-Age Women | Gynecology | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Abnormal Uterine Bleeding in Reproductive-Age Women

Educational Objective
To understand how to diagnose and treat Abnormal Uterine Bleeding in women
1 Credit CME

Abnormal uterine bleeding (AUB) in reproductive-age women (defined as abnormal in duration, quantity, or timing) is experienced by approximtely one-third of all women throughout their lifetime, impairs quality of life, and can be effectively managed medically in most cases.1

To minimize confusion associated with previously used terms including menorrhagia and meno-metrorrhagia, the International Federation of Gynecology and Obstetrics introduced updated terminology for AUB in nonpregnant women in 2011. Heavy menstrual bleeding (HMB) refers to ovulatory (cyclic) bleeding exceeding 8 days’ duration or heavy enough to interfere with a woman’s quality of life, a pattern of AUB distinct from the irregular bleeding associated with ovulatory dysfunction (AUB-O).1

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

Article Information

Published Online: May 9, 2019. doi:10.1001/jama.2019.5248

Conflict of Interest Disclosures: Dr Kaunitz reports receipt of personal fees from Bayer (consultant), Allergan, Pfizer, and UpToDate (royalties); and grants (to the University of Florida) from Allergan, Bayer, Medicines360.

Additional Contributions: Karen K. Kaunitz, Esq, and Jonathan D. Kaunitz, MD, provided editorial review of this manuscript.

References
1.
Munro  MG, Critchley  HOD, Fraser  IS,  et al.  The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years.  Int J Gynaecol Obstet. 2018;143(3):393-408.PubMedGoogle ScholarCrossref
2.
American College of Obstetricians and Gynecologists.  Diagnosis of abnormal uterine bleeding in reproductive-aged women, No.128.  Obstet Gynecol. 2012;120(7):197-206.PubMedGoogle Scholar
3.
Curtis  KM, Tepper  NK, Jatlaoui  TC,  et al.  US Medical eligibility criteria for contraceptive use, 2016.  MMWR Recomm Rep. 2016;65(3):1-103.PubMedGoogle ScholarCrossref
4.
National Institute for Health and Care Excellence.  Heavy menstrual bleeding. http://nice.org.uk/guidance/ng88. Accessed October 26, 2018.
5.
Kaunitz  AM, Bissonnette  F, Monteiro  I,  et al.  Levonorgestrel-releasing intrauterine system or medroxyprogesterone for heavy menstrual bleeding.  Obstet Gynecol. 2010;116(3):625-632.PubMedGoogle ScholarCrossref
6.
Wu  JP, Moniz  MH, Ursu  AN.  Long-acting reversible contraception-highly effacious, safe, and underutilized.  JAMA. 2018;320(4):397-398.PubMedGoogle ScholarCrossref
7.
Ylikorkala  O, Pekonen  F.  Naproxen reduces idiopathic but not fibromyoma-induced menorrhagia.  Obstet Gynecol. 1986;68(1):10-12.PubMedGoogle Scholar
8.
Stoffel  NU, Cercamondi  CI, Brittenham  G,  et al.  Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women.  Lancet Haematol. 2017;4(11):e524-e533.PubMedGoogle ScholarCrossref
9.
Lethaby  A, Penninx  J, Hickey  M, Garry  R, Marjoribanks  J.  Endometrial resection and ablation techniques for heavy menstrual bleeding.  Cochrane Database Syst Rev. 2013;(8):CD001501.PubMedGoogle Scholar
10.
de Bruijn  AM, Ankum  WM, Reekers  JA,  et al.  Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids.  Am J Obstet Gynecol. 2016;215(6):745.e1-745.e12.PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close