Dysfunctional uterine bleeding risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
Diseases presenting with dysfunctional uterine bleeding have a multitude of risk factors. Some that are commonly found in multiple conditions include those where [[estrogen]] exposure is uncontrolled and excessive. Some examples include early onset of [[menarche]] and late onset of [[menopause]], [[obesity]], [[Anovulation|anovulatory]] conditions such as [[PCOS]], estrogen exclusive hormonal contraceptives and [[tamoxifen]] therapy for breast cancer. It is to be notes that [[smoking]] has actually resulted in a reduced risk of some disease, due to its anti-estrogenic causes. The efficacy of smoking in preventing DUB is questionable considering the multitude of other diseases this behavioural activity results in. Although some conditions affected women of all ages, [[adenomyosis]] and [[Endometrial cancer|malignancy]] were found to affect older woman. | |||
==Risk Factors== | ==Risk Factors== | ||
Dysfunctional uterine bleeding may be due to many various diseases and although many have similar risk factors, it may be helpful to understand them individually based on the underlying cause. | |||
{| class="wikitable" | |||
|+ | |||
Risk factors of underlying conditions causing DUB | |||
!Condition causing DUB | |||
!Risk Factors | |||
|- | |||
|'''[[Polyps]]''' | |||
| | |||
* Increased [[blood pressure]] | |||
* [[Obesity]] | |||
* Use of [[Tamoxifen]] for [[Breast cancer|breast cancer therapy]] | |||
|- | |||
|'''[[Adenomyosis]]''' <ref name="pmid30969690">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30969690 | doi= | pmc= | url= }}</ref> <ref name="pmid24771944">{{cite journal| author=Taran FA, Stewart EA, Brucker S| title=Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. | journal=Geburtshilfe Frauenheilkd | year= 2013 | volume= 73 | issue= 9 | pages= 924-931 | pmid=24771944 | doi=10.1055/s-0033-1350840 | pmc=3859152 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24771944 }}</ref> | |||
| | |||
* Age: More common in the fourth and fifth decade of life | |||
* Early [[menarche]] | |||
* Late [[menopause]] | |||
* Short [[menstrual cycles]] | |||
* [[Obesity]] | |||
* Use of [[oral contraceptives]] | |||
* [[Multiparity]] and [[Pregnancy]] | |||
* Previous [[ectopic pregnancy]] | |||
* [[Tamoxifen]] use | |||
* Prior uterine surgeries ([[cesarean section]], [[myomectomy]], [[Dilation and curettage (patient information)|dilation and curettage]]) | |||
* Smoking has been shown to reduce the risk in some cases due to its estrogenic effects | |||
|- | |||
|'''[[Leiomyoma]]''' <ref name="pmid30855861">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=30855861 | doi= | pmc= | url= }}</ref> | |||
| | |||
* Race (more prevalent in those of African descent) | |||
* Early [[menarche]] | |||
* [[Obesity]] | |||
* Use of [[oral contraceptive]]<nowiki/>s; the use of progestin-only contraceptives were shown to reduce the risk of leiomyoma | |||
* Multiparity has also been shown to reduce the risk | |||
|- | |||
|'''[[Malignancy]] and [[hyperplasia]]''' <ref name="pmid32965984">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=32965984 | doi= | pmc= | url= }}</ref> <ref name="pmid24313431">{{cite journal| author=Ali AT| title=Risk factors for endometrial cancer. | journal=Ceska Gynekol | year= 2013 | volume= 78 | issue= 5 | pages= 448-59 | pmid=24313431 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24313431 }}</ref> | |||
| | |||
* Race (incidence is twice in African women compared to Caucasian women) | |||
* Age: More common in the elderly | |||
* Early [[menarche]] | |||
* Late [[menopause]] | |||
* [[Obesity]] | |||
* [[Radiation]] exposure | |||
* [[Infertility]] | |||
* Long term use of [[Contraceptives|estrogen contraceptives]] | |||
* Smoking has been shown to reduce the risk in some cases due to its estrogenic effects | |||
|- | |||
|'''[[Coagulopathies]]''' | |||
| | |||
* Most often familial causes (eg, [[Von Willebrand disease]]) | |||
* Some conditions may be due to acquired coagulation defects (eg, use of [[anticoagulant]] medication, [[DIC]]) | |||
|- | |||
|'''[[Polycystic Ovarian Syndrome]]''' | |||
| | |||
* [[Hyperinsulinemia]] secondary to [[insulin resistance]]; associated with [[Diabetes mellitus type 2|type 2 diabetes mellitus]] | |||
* [[Obesity]] | |||
* Family history of PCOS among first-degree relatives | |||
* [[Adrenarche|Premature adrenarche]] | |||
* Fetal [[androgen]] exposure | |||
* [[Low birth weight]] | |||
|- | |||
|'''Endometrial disorders ([[Endometriosis]])''' | |||
| | |||
* Presence of cervical [[stenosis]] and other congenital outflow obstructions (leads to the retrograde efflux of the [[Menstrual bleeding|menstrual]] fluid into the [[fallopian tubes]] and [[peritoneal cavity]]) | |||
* [[Caffeine]] or [[alcohol]] use | |||
* [[First degree relative|First-degree family relative]] with [[endometriosis]] | |||
* Nulliparity | |||
* [[Menarche]] at less than 11 years of age | |||
* Short [[menstrual cycle]] length | |||
* Tall stature | |||
|} | |||
Revision as of 10:12, 7 March 2022
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Dysfunctional uterine bleeding Microchapters |
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Differentiating Dysfunctional uterine bleeding from other Diseases |
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Dysfunctional uterine bleeding risk factors On the Web |
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Risk calculators and risk factors for Dysfunctional uterine bleeding risk factors |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Arooj Naz
Overview
Diseases presenting with dysfunctional uterine bleeding have a multitude of risk factors. Some that are commonly found in multiple conditions include those where estrogen exposure is uncontrolled and excessive. Some examples include early onset of menarche and late onset of menopause, obesity, anovulatory conditions such as PCOS, estrogen exclusive hormonal contraceptives and tamoxifen therapy for breast cancer. It is to be notes that smoking has actually resulted in a reduced risk of some disease, due to its anti-estrogenic causes. The efficacy of smoking in preventing DUB is questionable considering the multitude of other diseases this behavioural activity results in. Although some conditions affected women of all ages, adenomyosis and malignancy were found to affect older woman.
Risk Factors
Dysfunctional uterine bleeding may be due to many various diseases and although many have similar risk factors, it may be helpful to understand them individually based on the underlying cause.
| Condition causing DUB | Risk Factors |
|---|---|
| Polyps |
|
| Adenomyosis [1] [2] |
|
| Leiomyoma [3] |
|
| Malignancy and hyperplasia [4] [5] |
|
| Coagulopathies |
|
| Polycystic Ovarian Syndrome |
|
| Endometrial disorders (Endometriosis) |
|
References
- ↑ "StatPearls". ( ). 2022: . PMID 30969690.
- ↑ Taran FA, Stewart EA, Brucker S (2013). "Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy". Geburtshilfe Frauenheilkd. 73 (9): 924–931. doi:10.1055/s-0033-1350840. PMC 3859152. PMID 24771944.
- ↑ "StatPearls". ( ). 2022: . PMID 30855861.
- ↑ "StatPearls". ( ). 2022: . PMID 32965984 Check
|pmid=value (help). - ↑ Ali AT (2013). "Risk factors for endometrial cancer". Ceska Gynekol. 78 (5): 448–59. PMID 24313431.