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Treating Abnormal Uterine Bleeding

Abnormal uterine bleeding is a common condition with many causes and treatment options. This series will focus on determining the best option for your patient, whether it be hormonal, nonhormonal, or surgical.

Moderated by:
Susan Tsai, MD
Assistant Professor, Assistant Professor of Obstetrics and Gynecology (Minimally Invasive Gynecologic Surgery), Northwestern Medicine
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Expert Presentations
Susan Tsai, MD
Assistant Professor, Obstetrics and Gynecology, Division of Minimally Invasive, Gynecologic Surgery, Northwestern University Feinberg School of Medicine
Linda C. Yang, MD, MS
Assistant Professor, Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Loyola University Medical Center
Courtney Lim, MD
Assistant Professor, Minimally Invasive Gynecologic Surgery, University of Michigan
Sangeeta Senapati, MD
Clinical Assistant Professor, Division of Gynecological Pain and Minimally Invasive Surgery, NorthShore University HealthSystem, Illinois
Latest Comments
"I am not the presenter, but I have only ever seen tranexamic acid (TXA) used in the OR - almost always with non-OB-Gyn cases. While I have not done much prenatal/intrapartum care in my own practice, TXA use has been endorsed for use in treating postpartum hemorrhage. I also recall some recommendations about using it in non-pregnant women for heavy uterine bleeding, though I do not know the quality or quantity of the data backing it offhand."
Raj Bhui, MD
Faculty, University of British Columbia Family Medicine Residency Program
"This was an exceptional, well-organized succinct presentation entitled “Medical Management of Abnormal Uterine Bleeding: More than Hormones” in your series on treating abnormal uterine bleeding.”  Your lecture was greatly enhanced by your practice as a Physician and your education/training in Gynecologic Surgery in the Department of Obstetrics and Gynecology @ the University of Michigan.  Again, your expertise in the treatment of patients with abnormal urine bleeding made you an exceptional specialist to present this section regarding the recommendations for appropriate medical MGT concerning AUB.


You thoroughly reviewed a case history pertaining to a 49 Y/O ♀ with a HX of estrogen receptor-positive/progesterone receptor-positive breast CA who underwent a mastectomy.  Where the patient post-operatively developed a DVT and presented for TX of AUB.  First, you reviewed the reasons to consider nonhormonal MGT of AUB.  Second, you methodically analyzed the pharmacologic treatments of NSAIDS, Tranexamic Acid, Desmopressin and Metformin indicating their MOA, TX regimens, contraindications and adverse reactions for heavy menstrual bleeding.  Third, you pointed out that restoration of ovulation can return in 1/3 of patients and even some women with polycystic ovarian syndrome with weight loss and exercise. Finally, you pointed to the fact that there isn’t any clear evidence to support herbal supplements for the TX of AUB.


I had an ~ 50 year old female in the ED with AUB, in taking her history I discovered that this patient was a chronic alcoholic.  She was pale, SOB, dizzy, and C/O feeling really tired.  I can’t remember her H/H @ this time, but it was low and I gave blood and she was referred immediately to OB/GYN.  I have always believed that her chronic dependence to ETOH made her condition worse.

Have you experienced AUB in your alcoholic patients and if so how often does this occur?

Thank You.

Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center

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