Abnormal Uterine Bleeding During the Reproductive Years


  • Bridget R. Davidson CNM, WHNP, MS, RN,

  • Christina M. DiPiero CNM, WHNP, MS, RN,

  • Kara D. Govoni CNM, WHNP, MS, RN,

  • Susan S. Littleton CNM, WHNP, MS, RN,

  • Jeremy L. Neal CNM, PhD, RN

Jeremy L. Neal, CNM, PhD, RN, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210-1289. E-mail: neal.167@osu.edu


Abnormal uterine bleeding is one of the most common reasons that reproductive-aged women seek health care. The causes are varied, depending in large part on the age and life stage of the woman. Thus, diagnosis requires a systematic approach that is driven by a thorough health history and review of presenting symptoms. In recent years, the treatment of abnormal uterine bleeding has moved away from surgical procedures in favor of more conservative, yet effective, hormonal therapy such as combined contraceptives and the levonorgestrel-releasing intrauterine system. Clinicians must be knowledgeable about the various abnormal uterine bleeding treatment options and partner with women to develop appropriate, individualized treatment plans. The purpose of this article is to synthesize the current literature to describe the contributing etiologies, common presentations, diagnosis, evaluation, and management of abnormal uterine bleeding.