Based on a long clinical experience, the author makes a critical analysis of the terminology and concept of irregular uterine bleeding. He highlights the frequent academic confusion concerning the terms dysfunctional uterine bleeding and abnormal uterine bleeding, which raises questions on the diagnosis and treatment of these pathologies. The author tries to rationalize and to simplify the clinical investigation emphasizing the common procedures available in any office. For such aim, we should answer two basic questions: Is the bleeding originated from an organic or endocrine cause? If endocrine, is it ovulatory or anovulatory? By the same token, the treatment is limited to two or three simple and efficient schemes that work also as a differential diagnostic tool. If a rational hormonal scheme, based on the knowledge of the physiopathology of the process, doesn’t stop the bleeding, it certainly is not from an endocrine cause. This fact will force us to improve our investigation to identify the specific organic cause.
Dysfunctional uterine bleeding; Menorrhagia; Polymenorrhea; Oligomenorrhea
