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The physiological cyclical uterine bleeding occurring due to the shedding of the
interaction of various hormones of the hypothalamus, pituitary and the ovaries, which
functioning of the HPO axis and the anatomical patency of the genital tract.
The duration of a normal menstrual cycle varies between 21-35 days with an average
of 28 days, duration of menstruation being 4-5 days and the amount of blood loss estimated
to be 20-80 ml with an average of 35 ml.8,9 The menstrual discharge consists of uterine blood,
mucus, vaginal epithelial cells, endometrial shreds, various prostaglandins and enzymes
The onset of first menstruation (menarche) varies between 11-15 years. The
menstrual cycle is temporarily suspended during pregnancy and lactation and it ceases at the
bleeding without any clinically detectable organic, systemic and iatrogenic cause.1 It is
DUB is a common gynecological disorder affecting about 10-15% of the women in the
with bleeding being either excessive in amount (>80 ml) or duration (>7 days) or both.