Abnormal uterine bleeding in perimenopause

Abstract

Abnormal uterine bleeding (AUB) is one of the most common gynecological complaints. The availability of diagnostic methods has become wider, which makes it possible to effectively diagnose and treat menstrual disorders in an outpatient setting. This analytical review considers the advantages and disadvantages of transvaginal ultrasound examination, blind endometrial biopsy, and office hysteroscopy. The most effective treatments for patients with AUB are hormonal birth control pills, especially those with a short hormone-free interval, placement of the levonorgestrel-releasing intrauterine system, inclusion of the latest treatments with antifibrinolytic drugs and selective progesterone receptor modulators, as well as minimally invasive techniques. In other cases, surgical hysteroscopy and endometrial ablation are proven treatments that provide both long-term and short-term effects against uterine bleeding, which can avoid or delay hysterectomy.