ABSTRACT
Almost 90% of women will have four to eight years of menstrual cycle changes before menopause. It is important to distinguish irregular bleeding during the perimenopause from abnormal uterine bleeding. Abnormal uterine bleeding (AUB) in non-pregnant women is a common problem. It tends to be more common during the fifth decade of life (the perimenopausal years). AUB refers to the symptoms of excessive, prolonged, unexpected, or acyclic bleeding, regardless of diagnosis or cause, whereas dysfunctional uterine bleeding (DUB) is a diagnostic term for any abnormal bleeding from an essentially normal uterus. During the perimenopause, AUB is related to both aberrant hormonal function of the aging ovaries and to uterine abnormalities. This is reflected by the perimenopausal peak in hysterectomy rates for these indications (2). Various patterns of AUB are described in Table 1.
