Abnormal uterine bleeding (AUB) is one of the most common gynaecological problems affecting about 20% of premenopausal and up to 5% of postmenopausal women.

For premenopausal women, vaginal bleeding is considered abnormal when menstruation is heavy, painful or irregular & causing troublesome symptoms. Abnormal bleeding may also be intermenstrual or postcoital (IMB or PCB).

Postmenopausal bleeding (PMB), when not associated with HRT should always be considered abnormal. The incidence of malignancy in this group approaches 10%.For those taking HRT, abnormal bleeding is fairly common, particularly on starting therapy.

In about 35% of cases an organic/pathological lesion is identified within the pelvic cavity (see diagram below). Women without pelvic pathology (60%) are normally are as Dysfunctional Uterine Bleeding (DUB). In a very small minority (<5%) of women especially younger women haemotological problems like Von Willebrands disease or hypothyroidism may present with abnormal bleeding.