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Chapter 2 - Abnormal Uterine Bleeding

Published online by Cambridge University Press:  23 October 2024

By
Denise R. Nebgen  and
Dawn Palaszewski
Edited by
Laurie J. Mckenzie  and
Denise R. Nebgen
Laurie J. Mckenzie
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
Denise R. Nebgen
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
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Summary

Obstetrician-gynecologists are frequently consulted during an episode of abnormal uterine bleeding (AUB) to stop bleeding acutely and to prevent further bleeding during cancer treatment. Women with hematologic malignancies, such as acute myelogenous leukemia (AML), are the most frequently affected and new onset heavy menstrual bleeding may be the chief complaint leading to their diagnosis. Cancer and cancer treatments including chemotherapy, total body irradiation, and conditioning regimens for bone marrow or stem cell transplant can induce thrombocytopenia and lead to AUB. Main treatment options include oral contraceptive pills (OCPs), gonadotropin-releasing hormone (GnRH) agonists, and progestin-only hormone therapy. Algorithms are available to guide treatment and medical management is first line, especially in patients who have not completed childbearing. The risk of venous thromboembolism and need for contraception are special considerations when choosing a treatment for AUB in this patient population.

Keywords

abnormal uterine bleeding (AUB)acute myelogenous leukemiaheavy menstrual bleedingchemotherapystem cell transplantthrombocytopeniaoral contraceptive pillsgonadotropin-releasing hormone (GnRH) agonistsAUB algorithmvenous thromboembolism
Type
Chapter
Information
Caring for the Female Cancer Patient
Gynecologic Considerations
 , pp. 24 - 37
Publisher: Cambridge University Press
Print publication year: 2024

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