Anovulatory Bleeding: Clinical Management and Nursing Considerations-An Updated Review
Abstract
Background: Anovulatory bleeding (AUB-O) is a prevalent form of abnormal uterine bleeding characterized by irregular, unpredictable, and frequently heavy menstrual episodes. It results primarily from dysfunction of the hypothalamic–pituitary–ovarian axis, leading to chronic anovulation, unopposed estrogen exposure, and endometrial instability. The condition affects women across reproductive life stages and significantly impacts quality of life, fertility, and long-term endometrial health.
Aim: This review aims to synthesize current evidence regarding the etiology, clinical presentation, diagnostic approach, and management strategies for anovulatory bleeding, highlighting the multidisciplinary role of nursing, clinical evaluation, and patient education.
Methods: A comprehensive narrative review of clinical guidelines, observational studies, and contemporary literature was conducted, with emphasis on endocrine factors, epidemiology, diagnostic criteria, and therapeutic interventions relevant to the management of AUB-O.
Results: AUB-O arises from physiological or pathological disturbances of ovulation, including PCOS, thyroid dysfunction, hyperprolactinemia, stress, medication effects, and extremes of body weight. Diagnosis requires exclusion of pregnancy and structural causes through detailed history, physical examination, laboratory assessment, and imaging. Management includes hormonal regulation, progestin therapy, combined hormonal contraception, lifestyle modification, ovulation induction for infertility, and surgical interventions when indicated. Early evaluation reduces the risk of anemia, endometrial hyperplasia, and malignancy, while structured patient education enhances adherence and outcomes.
Conclusion: AUB-O is a multifactorial condition requiring timely recognition and individualized clinical management. Integration of hormonal therapy, lifestyle interventions, specialist referral, and patient-centered nursing care is essential for optimizing reproductive and overall health outcomes.
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Copyright (c) 2025 Khulud Mohammed Saleh Zaybi, Mushyirah Ahmed A Hadadi, Sabah Shatty Shehan Alonazi, Salman Aboud Alharbi, Msoaad Hadi Mohmmed Masrahi, Abrar Ali Khormi, Maram Radhi Alanazi, Manar Radi Al-Anzi, Fatmah Abdullah Saad Alzaid, Maram Moghram Ali Moghram, Amal Mohammed Omar Alsebyani
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