{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T18:28:21Z","timestamp":1782239301326,"version":"3.54.5"},"reference-count":50,"publisher":"ALUNA","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Based on the analysis of information from available sources of scientific literature, the article provides an overview of the problem of abnormal uterine bleeding and its causes. Preservation of women\u2019s reproductive health is an urgent problem of the whole world. AUB is a debilitating symptom that affects a large number of women and one of the most common gynecological abnormalities. \u0410UB, as a rule, does not threaten a woman\u2019s life, but significantly decreases its quality. Menstrual disorders affect all aspects of a woman\u2019s life, even increasing the risk of premature death. Women with AUB are more likely to seek medical care due to social and physical factors, while 50% of female patients have mental health problems due to anxiety and depression. Structural causes of uterine bleeding increase as a woman ages, which can affect reproductive health. Extragenital disorders are considered one of the most frequent causes of AUB. This is explained by the features of the endometrium, the state of which is influenced by general changes in a woman\u2019s hormonal status and the functional state of some organs and systems. AUB can be caused by diseases of the thyroid gland, uncorrected diabetes, obesity, blood coagulation disorders (most often von Willebrand\u2019s disease), infectious diseases, certain drugs (corticosteroids, antipsychotic or antiepileptic drugs), climate change and diet, psychological stress, etc. Management of patients with abnormal uterine bleeding is a complex problem that should include assessment of gynecological status and consultation of related specialists (endocrinologists, cardiologists, etc.).<\/jats:p>","DOI":"10.36740\/merkur202404112","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T10:19:28Z","timestamp":1727950768000},"page":"457-461","source":"Crossref","is-referenced-by-count":4,"title":["Abnormal uterine bleeding and its causes. Literature review"],"prefix":"10.36740","volume":"52","author":[{"given":"Liudmyla A.","family":"Vygivska","sequence":"first","affiliation":[{"name":"Kharkiv National Medical University , Kharkiv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesia A.","family":"Rudenko","sequence":"additional","affiliation":[{"name":"Aluna Publishing House, Konstancin -Jezierna, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olesia O.","family":"Pliekhova","sequence":"additional","affiliation":[{"name":"Kharkiv National Medical University , Kharkiv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor Yu.","family":"Rakytianskyi","sequence":"additional","affiliation":[{"name":"Kharkiv National Medical University , Kharkiv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22436","published-online":{"date-parts":[[2024]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 2019;220(6):569.e1-569.e7. doi:10.1016\/j.ajog.2019.02.048","DOI":"10.1016\/j.ajog.2019.02.048"},{"key":"ref1","unstructured":"2. Hale K. Abnormal Uterine Bleeding: A Review. US Pharm. 2018;43(9):HS2-HS9."},{"key":"ref2","unstructured":"3. Davis E, Sparzak PB. Abnormal Uterine Bleeding. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532913\/"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4. ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121(4):891\u2013896. doi: 10.1097\/01.AOG.0000428646.67925.9a","DOI":"10.1097\/01.aog.0000428646.67925.9a"},{"key":"ref4","unstructured":"5. Davis E, Sparzak PB. Abnormal Uterine Bleeding. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532913\/"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6. Kwak Y, Kim Y, Baek KA. Prevalence of irregular menstruation according to socioeconomic status: a population-based nationwide cross-sectional study. PLoS One 2019;14:e0214071.10.1371\/journal.pone.0214071","DOI":"10.1371\/journal.pone.0214071"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. G\u00fcnther V, Bauer M, Maass-Poppenhusen K, Maass N, Alkatout I. Pediatric and adolescent gynecology- a current overview. J Turk Ger Gynecol Assoc. 2023;24(1):65-73. doi: 10.4274\/jtgga.galenos.2022.2022-5-4","DOI":"10.4274\/jtgga.galenos.2022.2022-5-4"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. Wongwananuruk T, Rattanachaiyanont M, Dangrat C et al. Quality of life in Thai women with various types of abnormal uterine bleeding. Int J Gynaecol Obstet. 2022 Dec;159(3):711-718. doi: 10.1002\/ijgo.14272","DOI":"10.1002\/ijgo.14272"},{"key":"ref8","unstructured":"9. Hale K. Abnormal Uterine Bleeding: A Review. US Pharm. 2018; 43(9): HS2\u2013HS9."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. Saei Ghare Naz M, Rostami Dovom M, Ramezani Tehrani F. The Menstrual Disturbances in Endocrine Disorders: A Narrative Review. Int J Endocrinol Metab. 2020;18(4):e106694. doi:10.5812\/ijem.106694","DOI":"10.5812\/ijem.106694"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"11. Hapangama DK, Bulmer JN. Pathophysiology of heavy menstrual\u043c\u043cbleeding. Women\u2019s Health. 2016;12(1):3-13. doi:10.2217\/whe.15.81","DOI":"10.2217\/whe.15.81"},{"key":"ref11","unstructured":"12. Gynecologic Endocrinology Subgroup, Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. [Chinese guideline for diagnosis and management of abnormal uterine bleeding caused by ovulatory dysfunction]. Zhonghua Fu Chan Ke Za Zhi. 2018;53(12):801-807. doi: 10.3760\/cma-.j.issn.0529-567x.2018.12.001"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13. Nouri M, Tavakkolian A, Mousavi SR. Association of dysfunctional uterine bleeding with high body mass index and obesity as a main predisposing factor. Diabetes Metab Syndr. 2014;8(1):1-2. doi: 10.1016\/j.dsx.2013.10.013","DOI":"10.1016\/j.dsx.2013.10.013"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14. Sharma AS, Gupta S. Analysis of body mass index in patients with abnormal uterine bleeding. Int J Clin Obstet Gynaecol 2019;3(1):92-95. doi: 10.33545\/gynae.2019.v3.i1b.18","DOI":"10.33545\/gynae.2019.v3.i1b.18"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"15. Zhang CY, Li H, Zhang S, et al. Abnormal uterine bleeding patterns determined through menstrual tracking among participants in the Apple Women\u2019s Health Study. American Journal of Obstetrics and Gynecology. Published online October 2022. doi:10.1016\/j.ajog.2022.10.02","DOI":"10.1016\/j.ajog.2022.10.029"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"16. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2014;43(1):123-47.","DOI":"10.1016\/j.ecl.2013.10.003"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"17. Jain V, Chodankar RR, Maybin JA, Critchley HOD. Uterine bleeding: how understanding endometrial physiology underpins menstrual health. Nat Rev Endocrinol. 2022;18(5):290-308. doi: 10.1038\/s41574-021-00629-4","DOI":"10.1038\/s41574-021-00629-4"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"18. McDonald ME, Bender DP. Endometrial Cancer: Obesity, Genetics, and Targeted Agents. Obstet Gynecol Clin North Am. 2019;46(1):89-105. doi:10.1016\/j.ogc.2018.09.006","DOI":"10.1016\/j.ogc.2018.09.006"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"19. Itriyeva K. The effects of obesity on the menstrual cycle. Curr Probl Pediatr Adolesc Health Care. 2022;52(8):101241. doi: 10.1016\/j.cppeds.2022.101241","DOI":"10.1016\/j.cppeds.2022.101241"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"20. Reavey JJ, Walker C, Murray AA, Brito-Mutunayagam S, Sweeney S, Nicol M, et al. Obesity is associated with heavy menstruation that may be due to delayed endometrial repair. J Endocrinol. 2021;249(2):71-82. doi: 10.1530\/JOE-20-0446","DOI":"10.1530\/joe-20-0446"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"21. Quereval\u00fa-Pancorbo I, Rojas-Cama LF, Soncco-Llulluy F, et al. Abnormal uterine bleeding and associated factors: a cross-sectional study in high-performance Peruvian athletes. BMJ Open Sport Exerc Med. 2024;10(2):e001820. doi: 10.1136\/bmjsem-2023-001820","DOI":"10.1136\/bmjsem-2023-001820"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"22. Onieva-Zafra MD, Fern\u00e1ndez-Mart\u00ednez E, Abreu-S\u00e1nchez A, et al. Relationship between Diet, Menstrual Pain and other Menstrual Characteristics among Spanish Students. Nutrients. 2020;12(6):1759. doi:10.3390\/nu12061759","DOI":"10.3390\/nu12061759"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"23. Mumusoglu S, Okan Yildiz B. Polycystic ovary syndrome phenotypes and prevalence: Differential impact of diagnostic criteria and clinical versus unselected population. Curr. Opin. Endocrinol. Metab. Res. 2020;12:66\u201371. doi: 10.1016\/j.coemr.2020.03.004","DOI":"10.1016\/j.coemr.2020.03.004"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"24. Jeanes Y, Reeves S. Metabolic Consequences of Obesity and Insulin Resistance in Polycystic Ovary Syndrome: Diagnostic and Methodological Challenges. Nutr. Res. Rev. 2017;30:97\u2013105. doi:10.1017\/s0954422416000287","DOI":"10.1017\/s0954422416000287"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"25. Wang YX, Shan Z, Arvizu M, et al. Associations of Menstrual Cycle Characteristics Across the Reproductive Life Span and Lifestyle Factors with Risk of Type 2 Diabetes. JAMANetw. Open. 2020;3:e2027928","DOI":"10.1001\/jamanetworkopen.2020.27928"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"26. Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A. Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update. Arch Gynecol Obstet. 2021;303:631\u2013643. doi:10.1007\/s00404-020-05951-2","DOI":"10.1007\/s00404-020-05951-2"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"27. Li X, Yang D, Pan P, et al. The Degree of Menstrual Disturbance Is Associated With the Severity of Insulin Resistance in PCOS. Front Endocrinol (Lausanne). 2022;13:873726. doi:10.3389\/fendo.2022.873726","DOI":"10.3389\/fendo.2022.873726"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"28. Brower M, Brennan K, Pall M, et al. The Severity of Menstrual Dysfunction as a Predictor of Insulin Resistance in PCOS. J Clin. Endocrinol. Metab. 2013;98:E1967\u2013E1971. doi:10.1210\/jc.2013-2815","DOI":"10.1210\/jc.2013-2815"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"29. Polak K, Czyzyk A, Simoncini T, et al. New markers of insulin resistance in polycystic ovary syndrome. J Endocrinol Invest. 2017;40:1\u20138. doi:10.1007\/s40618-016-0523-8","DOI":"10.1007\/s40618-016-0523-8"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"30. Ezeh U, Pisarska MD, Azziz R. Association of severity of menstrual dysfunction with hyperinsulinemia and dysglycemia in polycystic ovary syndrome. Hum Reprod. 2022;37(3):553-564. doi:10.1093\/humrep\/deac001","DOI":"10.1093\/humrep\/deac001"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"31. Thong EP, Codner E, Laven JSE, et al. Diabetes: a metabolic and reproductive disorder in women. Lancet Diabetes Endocrinol. 2020;8(2):134-149. doi:10.1016\/S2213-8587(19)30345-6","DOI":"10.1016\/s2213-8587(19)30345-6"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"32. \u0141ebkowska A, Adamska A, Krentowska A, et al. The Influence of Prepubertal Onset of Type 1 Diabetes and Age of Menarche on Polycystic Ovary Syndrome Diagnosis. J Clin Endocrinol Metab. 2021;106(6):1811-1820. doi:10.1210\/clinem\/dgab062","DOI":"10.1210\/clinem\/dgab062"},{"key":"ref32","unstructured":"33. Kazerouni F, Amirrasouli H. Performance characteristics of three automated immunoassays for thyroid hormones. Caspian J Intern Med. 2012;3(2):400-104."},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"34. Dittrich R, Beckmann MW, Oppelt PG, et al. Thyroid hormone receptors and reproduction. J Reprod Immunol. 2011;90(1):58-66. doi: 10.1016\/j.jri.2011.02.009","DOI":"10.1016\/j.jri.2011.02.009"},{"key":"ref34","unstructured":"35. Rifai N, Horvath AR, Wittwer CT, editors. Tietz textbook of clinical chemistry and molecular diagnostics. 6th. St. Louis: Elsevier; 2018. p. 627."},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"36. Joshi BR, Rizal S, Subedi S. Thyroid Dysfunction in Patient with Abnormal Uterine Bleeding in a Tertiary Hospital of Eastern Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2021;59(239):635-639. doi:10.31729\/jnma.6487","DOI":"10.31729\/jnma.6487"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"37. Kattel P. Thyroid function test in abnormal uterine bleeding. Nepal Journal of Obstetric and Gynaecology. 2017;12((2)):74\u20138. doi:10.3126\/njog.v12i2.19959","DOI":"10.3126\/njog.v12i2.19959"},{"key":"ref37","unstructured":"38. Komathi R, Mallika A, Shantha A. Study of thyroid profile in abnormal uterine bleeding among reproductive age group women. International Journal of Current Medical Sciences. 2016;6(7):133\u20136."},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"39. Chang DH, Dumanski SM, Ahmed SB. Female Reproductive and Gynecologic Considerations in Chronic Kidney Disease: Adolescence and Young Adulthood. Kidney Int Rep. 2021;7(2):152-164. doi:10.1016\/j.ekir.2021.11.003","DOI":"10.1016\/j.ekir.2021.11.003"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"40. Lim VS, Henriquez C, Sievertsen G, et al. Ovarian function in chronic renal failure: evidence suggesting hypothalamic anovulation. Ann Intern Med. 1980;93(1):21-27. doi:10.7326\/0003-4819-93-1-21","DOI":"10.7326\/0003-4819-93-1-21"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"41. Palmer BF, Clegg DJ. Gonadal dysfunction in chronic kidney disease. Rev Endocr Metab Disord. 2017;18:117\u2013130. doi:10.1007\/s11154-016-9385-9","DOI":"10.1007\/s11154-016-9385-9"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"42. Irani M, Merhi Z. Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review. Fertil Steril. 2014;102(2):460-468.e3. doi:10.1016\/j.fertnstert.2014.04.046","DOI":"10.1016\/j.fertnstert.2014.04.046"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"43. Luk J, Torrealday S, Neal Perry G, et al. Relevance of vitamin D in reproduction. Hum Reprod. 2012;27(10):3015-27. doi: 10.1093\/humrep\/des248","DOI":"10.1093\/humrep\/des248"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"44. Moini A, Ebrahimi T, Shirzad N, et al. The effect of vitamin D on primary dysmenorrhea with vitamin D deficiency: a randomized double-blind controlled clinical trial. Gynecol Endocrinol. 2016;32(6):502-5. doi:10.3109\/09513590.2015.1136617","DOI":"10.3109\/09513590.2015.1136617"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"45. Drakopoulos P, van de Vijver A, Schutyser V, et al. The effect of serum vitamin D levels on ovarian reserve markers: a prospective cross-sectional study. Hum Reprod. 2017;32(1):208-214. doi:10.1093\/humrep\/dew304","DOI":"10.1093\/humrep\/dew304"},{"key":"ref45","unstructured":"46. Tehrani HG, Mostajeran F, Shahsavari S. The effect of calcium and vitamin D supplementation on menstrual cycle, body mass index and hyperandrogenism state of women with poly cystic ovarian syndrome. J Res Med Sci. 2014;19(9):875-880."},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"47. Zarei S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, et al. Effects of Calcium-Vitamin D and Calcium-Alone on Pain Intensity and Menstrual Blood Loss in Women with Primary Dysmenorrhea: A Randomized Controlled Trial. Pain Med. 2017;18(1):3-13. doi:10.1093\/pm\/pnw121","DOI":"10.1093\/pm\/pnw121"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"48. Merhi Z, Doswell A, Krebs K, et al. Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells. J Clin Endocrinol Metab. 2014;99(6):E1137-E1145. doi:10.1210\/jc.2013-4161","DOI":"10.1210\/jc.2013-4161"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"49. Singh V, Tamar N, Lone Z, et al. Association between serum 25-hydroxy vitamin D level and menstrual cycle length and regularity: A cross-sectional observational study. Int J Reprod Biomed. 2021;19(11):979-986. doi:10.18502\/ijrm.v19i11.9913","DOI":"10.18502\/ijrm.v19i11.9913"},{"key":"ref49","unstructured":"50. Blahoveshchenskyi R\u0415. Optymizatsiia diahnostyky i likuvannia zhinok reproduktyvnoho viku z anomalnymy matkovymy krovotechamy ta ekstrahenitalnoiu patolohiieiu [dysertatsiia]. Kharkiv: Kharkiv. nats. med. un-t; 2023. 187s."}],"container-title":["Polski Merkuriusz Lekarski"],"original-title":[],"language":"en","deposited":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T10:19:38Z","timestamp":1727950778000},"score":1,"resource":{"primary":{"URL":"https:\/\/polskimerkuriuszlekarski.pl\/wp-content\/uploads\/library\/PolMerkurLek2024i4.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":50,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024]]},"published-print":{"date-parts":[[2024,8]]}},"URL":"https:\/\/doi.org\/10.36740\/merkur202404112","archive":["Internet Archive"],"relation":{},"ISSN":["1426-9686"],"issn-type":[{"value":"1426-9686","type":"print"}],"subject":[],"published":{"date-parts":[[2024]]}}}