Case history
Case history #1
A 15-year-old girl presents to the emergency department with a history of excessive vaginal bleeding that started yesterday but has been increasing since early morning. She had her first period (menarche) at the age of 13 years and since then her periods have been irregular and unpredictable. She denies any sexual activity and a pregnancy test is negative. She looks pale but her vital signs are stable. Further assessment reveals significant menstrual bleeding that soaks one pad every 3 hours. She is admitted to the hospital.
Case history #2
A 47-year-old woman presents to her gynecologist with a history of persistent vaginal bleeding for the past 2 weeks. Over the last year, her periods have been longer and irregular. She is sexually active and denies any exogenous hormone use. Her partner had a vasectomy 5 years ago. Her examination is unremarkable except for minimal menstrual bleeding. Pregnancy is excluded.
Other presentations
AUB has a wide spectrum of presentations that range from heavy menstrual bleeding that warrants hospital admission and emergency treatment, to occasional irregular spotting at any time throughout the menstrual cycle. Women at the extremes of reproductive age (just after puberty and before menopause) are at particular risk.
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