Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life.

1. Dr. Laxmi Shrikhande
MD; FICOG ;FICMU
•Director-Shrikhande Fertility Clinic, Nagpur
•President Menopause Society, Nagpur
•National Corresponding Editor-The Journal of Obstetrics & Gynecology of India
•Senior Vice President FOGSI 2012
•Vice Chairperson elect ICOG
•Governing Council member ICOG 2012-2017
•Governing Council Member ISAR 2014-2019
•Governing Council Member IAGE for 3 terms
•Patron-Vidarbha Chapter ISOPARB
•Chairperson-HIV/AIDS Committee, FOGSI (2007-09)
•Received Best Committee Award of FOGSI
•Received Bharat excellence Award for women’s health
•President Nagpur OB/GY Society 2005-06
•Associate member of RCOG
•Member of European Society of Human Reproduction
•Visited 96 FOGSI Societies as invited faculty
•Delivered 3 orations
•Publications-Thirteen National & seven International
•Presented Papers in FIGO, AICOG, SAFOG, AICC-RCOG conferences
•Conducted adolescent health programme for more than 15,000 adolescent girls

2. Medical Management of
AUB
Dr Laxmi Shrikhande
Director-Shrikhande Fertility Clinic
Nagpur

3. Abnormal Uterine Bleeding
• Not a diagnosis but symptom or sign
• Defined as any variation from the normal
menstrual cycle, and includes changes in regularity
and frequency of menses, in duration of flow, or in
amount of blood loss

4. Acute and Chronic AUB
• Acute: An episode of bleeding in a woman of
reproductive age, who is not pregnant, that is of
sufficient quantity to require immediate intervention
to prevent further blood loss
• Chronic: Bleeding that is abnormal in duration,
volume, and/or frequency and has been present for
at least 3 months

5. Advantages of PALM COEIN
• Simplified and unified terminology
• Allows clear focus of treatment concepts
• Facilitates clinical and scientific research collaboration
• Provides the basis to structure more effective clinical
teaching
• Serves to enhance and clarify communication within and
between specialties
All speak the same language

6. Work up of AUB
• Careful history
• Pelvic examination
• Ultrasound pelvis
• Complete hematological profile
• Dilatation and Curettage
• Hysteroscopy
• Specific tests to rule out cause of AUB

7. Treatment Objectives
• Women require rapid, safe and effective treatment
for their menstrual problems.
• The objectives of treatment are to
– control the acute bleeding,
– avert future episodes, and
– prevent a serious long-term consequence of anovulation,
endometrial cancer.

8. Medical Treatment for AUB
HORMONES
 Es+Pr
 Progestogens
 Estrogen
 Androgens +
Estrogen
 Danazol
 GnRha
SECOND LINE &
mostly Adjuvant
NSAIDs
Mefenamic acid
Ethamsylate
Antifibrinolytics
• EACA
• Tranexamic acid

9. Take Home Message
SAVE THE UTERUS !!

10. My World of
sharing happiness!
Shrikhande IVF &
Surrogacy Center
Ph- 91 96234 59766
shrikhandedrlaxmi@gmail.com

11. The Art of Living
Anything that
helps you to
become
unconditionally
happy and
loving is what is
called
spirituality.
H. H. Sri Sri Ravishakar