ABNORMAL UTERINE BLEEDING ASSOCIATED WITH IRON-DEFICIENCY ANEMIA - ETIOLOGY AND ROLE OF HYSTEROSCOPY

We reviewed the clinical and histologic records of 61 consecutive prem enopausal women with abnormal uterine bleeding and moderate to severe iron-deficiency anemia investigated in a tertiary care and referral ce nter. Excessive bleeding was caused by benign lesions in 67% of the ca ses and by anovulation in 25% and was unexplained in 8%. Hysteroscopy revealed an organic intrauterine lesion (submucous myomas in 38%, endo metrial polyps in 13%, submucous adenomyomas in 3%) that could be trea ted endoscopically in more than half the patients. In populations with out nutritional deficiencies, a woman of reproductive age with siderop enic anemia and no other evident cause of blood loss or systemic disea se should be considered menorrhagic until proven otherwise. Hysterosco py should be included in evaluations of abnormal uterine bleeding.