Abnormal uterine bleeding is defined as any bleeding outside of normal menstrual cycle with excessive duration, frequency and amount of loss. AUB accounts about 70% in perimenopausal women in gynaecology OPD. Abnormal uterine bleeding is not a disease, it is a symptom. The aim of the study was to evaluate abnormal uterine bleeding in perimenopausal women and to study the various menstrual abnormalities and causes of AUB in perimenopausal women.
Study design: This study was a hospital based cross sectional study which included 95 women in perimenopausal age group (40-51 years) with abnormal uterine bleeding. The history, clinical examination, USG and histopathological findings was collected. Clinical findings were classified by PALM-COEIN classification. All women underwent endometrial sampling to rule out endometrial pathology.
Results: The mean age of the patients was 44.89(±2.93) years. Parity of more than 2 (46.3%) was most common. Menorrhagia (58.9%) was the most common bleeding pattern followed menometrorrhagia (23.2%). Leiomyomo 37 (38.9%) was the most common clinical finding followed by adenomyosis 29 (30.5%). Ultrasonographically fibroid uterus (37.8%) was the most common USG findings followed by Adenomyosis (30.5%). The most common endometrial thickness was 9-12mm (43.1%). Histopathological examination revealed secretory phase endometrium (35.8%) was the most common finding followed by proliferative endometrium (20%).
Conclusion: Uterine fibroid was the leading cause of AUB. Clinical examination and ultrasound findings correlated well in the diagnosis of fibroids. Evaluation of the endometrium in perimenopausal women presenting with AUB is essential to rule out endometrial pathology.