Excessive Bleeding (DUB)

Dysfunctional uterine bleeding (DUB), also referred to as abnormal uterine bleeding, is any excessive menstrual or erratic vaginal bleeding. Normal menstruation occurs every 21 to 35 days in women.

Causes of Dysfunctional Uterine Bleeding

Some causes include, but are not limited to:

  • Hormonal imbalance such as thyroid disease, polycystic ovarian syndrome (PCOS), or the menopausal transition
  • Pregnancy
  • Certain medications such as birth control pills
  • Infection or inflammation of the cervix or uterine lining (endometrium)
  • Abnormal growths of the uterus or cervix (e.g. polyps or fibroids)
  • Cancer
  • Bleeding disorders

Symptoms of Dysfunctional Uterine Bleeding

Symptoms include:

  • Bleeding that occurs outside the normal menstruation cycle
  • Heavy bleeding between periods
  • Prolonged spotting or spotting between periods
  • Bleeding with large or many clots
  • Bleeding that lasts for more than 7 days, or fewer than 21 days between periods

You should call your doctor or proceed to the nearest emergency room immediately if you encounter weakness, fainting, dizziness, palpitations, pale skin, or soaking through a pad every hour.

Diagnosis of Dysfunctional Uterine Bleeding

Your doctor will consider your personal, medication, and family health history as well as complete details of your menstrual cycles (dates, length, and type of bleeding).  Your evaluation may include a physical exam, bloodwork, or imaging such as an ultrasound to elucidate the etiology for abnormal bleeding.

Treatment for Dysfunctional Uterine Bleeding

DUB may be treated with medications or surgery, depending on the etiology of your problem.


  • Hormonal medications may used to treat abnormal bleeding depend on your medical history, plans for pregnancy, and other medications you take. Hormones can be given as injections, pills, patches or through implants in the arm or uterus. The hormones are slowly released into the body by these means to control the abnormal bleeding.
  • Anti-inflammatory drugs which may help with bleeding as well as pain

Surgical treatment:

  • Your doctor may also discuss surgical treatment depending on the etiology of bleeding as well as your plans for pregnancy and childbearing. This may include surgery to remove abnormal growths such as fibroids or polyps, endometrial ablation to destroy the uterine lining, or removal of the uterus (hysterectomy).

Along with these treatments, you should take good care of yourself by eating a well-balanced diet, exercising, and getting the proper amount of sleep.

  • ACOG
  • AIUM
  • American Association of Gynecologic Laparoscopists
  • NYU langone Medical center
  • American Association for Accreditation of Ambulatory Surgery Facilities
  • UpToDate