Abnormal uterine bleeding

It is highly recommended that women with long-standing AUB, particularly when associated with anovulation, obesity, and age >45 years, be monitored due to the increased risk for endometrial hyperplasia and endometrial cancer. Follow-up with regular history and physical exam, with further investigations when needed, is usually adequate.

As AUB is a diagnosis of exclusion, serious underlying pathology may be overlooked during the course of AUB management. When the clinical picture of AUB is associated with the presence of significant risk factors of underlying pathology, and with atypical clinical presentations such as failure of medical treatment, further evaluation is mandatory.