The Role of Dydrogesterone in The Medical management of 100 cases of Dysfunctional Uterine Bleeding (DUB) Above 35 years of age

Abstract

Dysfunctional uterine bleeding or DUB are a large number of patients presenting in our OPDs and the problem is a major contributor to anaemia and disease in our society, mostly necessitating hysterectomy. This was a hospital based prospective study of 100 patients with DUB who were randomly selected, in our out patients (OPDs) between 1st August 2001 -  31st July 2002. common presentation was either menorrhagia or poly menorrhagia with ages varying between 35 - 50 years. 68 (68%) patients were between 35 - 44 years age groupa nd 32(32%) patients were 44 - 50 years old. in addition to Hb gm%, detailed haematological investigations were carried out. Transvaginal ultrasounds were done to specifically look for endometrial thickenss or pathology and ovarian screening to exclude any organic cause. 64 out of 100 patients showed increased endometrial thickness or irregularity and 32 out of these who were above 40 years oa ge had an endometrial biopsy to exclude any premalignant or malignant condition of the endometrium. All patients were put on dydrogesterone 10mg daily starting from day 14th to day 28th of the cycle for 3 - 6 months. Remarkably good cycle control and reduction in the amount of bleeding and days of menstruations, and improvement of Hb gm% levels were seen in 41 patients. 3 were lost of the follow up and 6 patients eventually needed hsyterectomy. The study proved that dydrogesterone is an effective agent for medcial treatment of dysfunctional uterine bleeding. Its use saved patients from hysterectomy thus decreasing exposure to the risk of general anaesthesia and surgery, also decreasing workload and economic burden on hospital, staff and the state.