Functional and dysfunctional uterine bleeding.

The patient who comes to the physician with abnormal bleeding represents an enormous responsibility. The various causative factors represent defects in numerous physiologic systems. The diagnosis of DUB still requires further investigation of the hormonal imbalance. Only when specific causes are known can the treatment be tailored to the particular patient. Recent scientific advances regarding possible cellular mechanisms for DUB make it mandatory that the primary physician be aware of available tests that may indicate the relative appropriateness of and prognosis for a particular therapy. The treatment is substitutional. If progesterone is missing, therefore,the treatment should replace it. Progesterone may be obtained endogenously by ovulation induction or exogenously by oral or parenteral progestogens.