Snapshot A 39-year-old woman presents with abnormal heavy menstrual bleeding along with increased pelvic pressure. She denies pain and is not using any hormonal contraception. She uses multiple sanitary pads per day. On pelvic examination, there is an enlarged uterus with asymmetric contours. The uterus is non-tender to palpation. (Uterine leiomyomas) SUMMARY Also known as dysfunctional uterine bleeding (DUB) Abnormal menstrual bleeding with regards to login to view 1 more bullet The patient must not be pregnant login to view 1 more bullet Etiology Causes include login to view 17 more bullets Pathogenesis login to view 6 more bullets Presentation Symptoms login to view 4 more bullets Physical exam login to view 3 more bullets Imaging studies transvaginal ultrasound login to view 1 more bullet STUDIES Evaluation is dependent on likely cause of AUB β-hCG login to view 2 more bullets Blood testing login to view 5 more bullets Endometrial biopsy login to view 4 more bullets Differential Refer to introduction (PALM-COEIN) Treatment Treat the underlying cause of AUB Treatment login to view 16 more bullets Surgical treatment login to view 9 more bullets Complications May be at increased risk for endometrial cancer or hyperplasia in AUB secondary to anovulation Prognosis Treatment may improve quality of life