超过半数的女性会在其育龄期中至少一次发生与妊娠无关的异常子宫出血 (AUB)。DUB 是一种排除性诊断,发生于近半数 AUB 病例中。高达 25% 的女性在生育年龄段会经历至少一次 DUB。[4]Cote I, Jacobs P, Cumming DC. Use of health services associated with increased menstrual loss in the United States. Am J Obstet Gynecol. 2003;188:343-348.http://www.ncbi.nlm.nih.gov/pubmed/12592237?tool=bestpractice.com[5]Hallberg L, Hogdahl AM, Nilsson L, et al. Menstrual blood loss - a population study. Variation at different ages and attempts to define normality. Acta Obstet Gynecol Scand. 1966;45:320-351.http://www.ncbi.nlm.nih.gov/pubmed/5922481?tool=bestpractice.com[6]Farrell E. Dysfunctional uterine bleeding. Aust Fam Physician. 2004;33:906-908.http://www.ncbi.nlm.nih.gov/pubmed/15584330?tool=bestpractice.com[7]Ewenstein BM. The pathophysiology of bleeding disorders presenting as abnormal uterine bleeding. Am J Obstet Gynecol. 1996;175:770-777.http://www.ncbi.nlm.nih.gov/pubmed/8828560?tool=bestpractice.com据信,仅四分之一的子宫出血过多的女性寻求医学治疗。英国 5% 的 30-49 岁女性和新西兰 2%-4% 的绝经前女性每年会因过多子宫出血而咨询全科执业医师。[8]Vessey MP, Villard-Mackintosh L, McPherson K, et al. The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol. 1992;90:402-407.http://www.ncbi.nlm.nih.gov/pubmed/1622913?tool=bestpractice.com[9]Reich H, Ribeiro SC, Vidali A. Hysterectomy as treatment for dysfunctional uterine bleeding. Baillieres Best Pract Res Clin Obstet Gynaecol. 1999;13:251-269.http://www.ncbi.nlm.nih.gov/pubmed/10755041?tool=bestpractice.com[10]Working Party of the National Health Committee New Zealand. Guidelines for the management of heavy menstrual bleeding. Wellington: Ministry of Health; 1998.http://www.moh.govt.nz/notebook/nbbooks.nsf/0/33E986412C26662CCC256E8900745222/$file/guidelines-management-heavy-menstrual-bleeding.pdfDUB 最常影响育龄期两端年龄(青春期后和绝经前)的女性以及受长期无排卵困扰的女性,特别是有多囊卵巢综合征的女性患者。[1]Speroff L, Fritz M, eds. Dysfunctional uterine bleeding. In: Clinical gynecologic endocrinology and infertility. 7th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2004:547-571.