What are the signs and symptoms of abnormal uterine bleeding (AUB)?

Updated: Dec 07, 2018
  • Author: Millie A Behera, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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AUB should be suspected in patients with unpredictable or episodic heavy or light bleeding despite a normal pelvic examination. Typically, the usual moliminal symptoms that accompany ovulatory cycles will not precede bleeding episodes.

Pathologic causes of anovulatory bleeding

Because AUB is considered a diagnosis of exclusion, the presence or absence of signs and symptoms of other causes of anovulatory bleeding must be determined.

Patients who report irregular menses since menarche may have polycystic ovarian syndrome (PCOS). PCOS is characterized by anovulation or oligo-ovulation and hyperandrogenism. These patients often present with unpredictable cycles and/or infertility, hirsutism with or without hyperinsulinemia, and obesity.

Other signs of underlying pathology include the following:

  • Thyroid enlargement or manifestations of hyperthyroidism or hypothyroidism

  • Galactorrhea: May suggest hyperprolactinemia

  • Visual field deficits: Raise suspicion of intracranial/pituitary lesion

  • Ecchymosis, purpura: Signs of bleeding disorder

See Clinical Presentation for more detail.

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