Abnormal uterine bleeding: causes, diagnosis, and treatment

Dubrovina S.O., Kirevnina L.V., Lesnoy M.N.

1) Rostov State Medical University, Ministry of Health of the Russian Federation, Rostov-on-Don, Russia; 2) A.K. Eramishantsev City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
Abnormal uterine bleeding (AUB) is one of the most common complaints encountered in gynecological practice. AUB negatively affects the physical, emotional, sexual, and professional aspects of women’s lives. The paper highlights the current view on the tactics of managing patients with AUB according to the current FIGO classification system. Patient management requires an individual approach to tailoring treatments to individual needs, taking into account not only the etiology of this abnormality, but also the somatic problems of the women and their reproductive plans. After verifying the diagnosis of the abnormality, a physician must pay attention to its pathogenetic validity, when choosing a therapy option, and to the advisability of using one or another method. The paper analyzes various hormonal drugs for AUB, including progestogens and hormonal contraceptives. If there is a need to prevent unwanted pregnancy, oral or intrauterine hormonal contraceptives may be recommended. However, when choosing a drug, in addition to its exerted effects, the safety profile should be taken into account, by assessing the benefit-risk ratio individually for each patient. One of the most preferred and pathogenetically grounded treatments is the use of progestogens. Among them, dydrogesterone occupies a special place due to its high efficacy in reducing the volume of blood loss, as well as its favorable safety profile, which makes it currently the most suitable drug for the treatment and secondary prevention of AUB.
Conclusion. Correctly chosen hormone therapy for women who need it makes it possible to improve patients’ health and to minimize the risks of adverse events.


abnormal uterine bleeding
combined oral contraceptives


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Received 22.10.2020

Accepted 25.12.2020

About the Authors

Svetlana O. Dubrovina, Doctor of Medicine, Full Professor, Senior Research Officer, Rostov State Medical University, Ministry of Health of the Russian Federation.
E-mail: s. dubrovina@gmail.com. ORCID: 0000-0003-2424-2672. 344022, Russia, Rostov-on-Don, per. Nakhichevanskii, 29.
Lilia V. Kirevnina, Ph.D. of Medical Sciences, obstetrician-gynecologist, City clinical hospital named after A.K. Eramishantsev, Moscow.
12932715, Russia, Moscow, Lenskaya str., 15.
Maxim N. Lesnoy, 6th year student, Rostov State Medical University, Ministry of Health of the Russian Federation. 344022, Russia, Rostov-on-Don, per. Nakhichevanskii, 29.

For citation: Dubrovina S.O., Kirevnina L.V., Lesnoy M.N. Abnormal uterine bleeding: causes, diagnosis, and treatment.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 1: 170-177 (in Russian)

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