CASE STUDY For Abnormal Uterine Bleeding

Amellyn L. Reyes BSN III-4

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OVERVIEW a. S/Sx Symptoms of dysfunctional uterine bleeding may include:

Bleeding or spotting from the vagina between periods Periods that occur less than 28 days apart (more common) or more than 35 days apart Time between periods changes each month Heavier bleeding (such as passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 - 3 hours in a row) Bleeding lasts for more days than normal or for more than 7 days

Other symptoms caused by changes in hormone levels may include:

Excessive growth of body hair in a male pattern (hirsutism) Hot flashes Mood swings Tenderness and dryness of the vagina

A woman may feel tired or have fatigue if she is loses too much blood over time. This is a symptom of anemia.

b. Etiology

When bleeding is not caused by your menstrual cycle, it is called abnormal or dysfunctional uterine bleeding. This is the most common cause of abnormal vaginal bleeding during a woman's childbearing years. Up to 10% of women may experience excessive bleeding at one time or another. African American women tend to have more episodes. When the complex hormonal processes of the menstrual cycle are interrupted, resulting in estrogen and progesteronelevels that are out of balance, excessive vaginal bleeding may occur. This bleeding is related to irregularities of your menstrual cycle without any disease. The diagnosis of dysfunctional uterine bleeding is a diagnosis of exclusion, which means that all other causes for the bleeding (including trauma, tumors, or diseases) have been looked for and determined not to be the cause of the bleeding.

Depending on the female adolescent or woman's age, there are different reasons for the person to have dysfunctional uterine bleeding. Dysfunctional uterine bleeding is usually associated with an anovulatory cycle. Anovulation occurs when a menstrual cycle occurs that does not result in the release of an egg from one of the ovaries. In some cases, dysfunctional uterine bleeding can occur with ovulation or the release of an egg from an ovary. When a woman does not produce an egg, there is still stimulation of the uterus from the hormone estrogen. Progesterone, a very important hormone produced by a growing egg, is absent. Therefore, the lining of the uterus becomes unusually thick and enlarged. Irregular shedding of the uterine lining and heavy bleeding occurs. The woman then experiences heavy, irregular vaginal bleeding (usually painless). The most common cause of dysfunctional uterine bleeding in a female adolescent is anovulation.

In the first two years of a female adolescent having a menstrual cycle, 85% of the menstrual cycles can occur without the release of an egg. As the female adolescent gets older, the percentage of cycles that are anovulatory decreases, and she is more likely to experience normal periods. By the time the the female adolescent has had a menstrual cycle for six years, fewer than 20% of cycles will occur without an egg being released from one of the ovaries.

c. Risk Factors obesity polycystic ovary syndrome endometriosis prolonged estrogen or progesterone use Stress crash diets irregular sleep patterns overwork vigorous exercise drug or alcohol abuse can also disrupt normal hormone balance and cause dysfunctional uterine bleeding.

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PATIENTS PROFILE Name: Patient X Age: 14 years old Birthday: July 25, 1998 Address: Sta. Cruz Guimba Nueva Ecija Civil Status: Single Occupation: Student Fathers Name: Domingo Agustin Mothers Name: Violora Alivia