[Abnormal menstrual bleeding].

Abnormal uterine bleeding (DUB) is one of the most frequent gynecologic problems. Not every DUB is pathological, yet most women feel disordered. Recurrent DUB needs a diagnostic work-up and has to be treated frequently. 80% of cases are due to hormonal disorders, called dysfunctional uterine bleeding, the others are of organic cause (polyps, myomas). The diagnostic work-up is essentially based on the vaginal ultrasound. Standard invasive diagnostic includes the combination of hysteroscopy and curettage or guided biopsy. Laboratory tests are rarely indicated. Medical treatment is based on gestagens, estrogens or combinations thereof. If contraception is needed, ovulation inhibitors are chosen. In case of contraindications, non-steroid antirheumatics or antifibrinolytics are efficacious alternatives. Organic causes of abnormal bleeding are treated by hysteroscopy. Relapse may necessitate destruction of the endometrium or hysterectomy.