الفهرس 
Abnormal uterine bleedingOnly 14 pages are availabe for public view
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Abstract
Introduction
Abnormal uterine bleeding (a term which refers to menstrual bleeding of abnormal quantity and/orduration) is a common gynecologic complaint accounting for one-third of outpatient visits togynecologists(1).
Vaginal bleeding occurs in approximately 4 to 11 percent of premenopausal women. The incidence of bleeding appears to correlate with time since menopause, with the likelihood of bleeding decreasing over time. As an example, in a study that asked 271 premenopausal women to complete a daily record, the estimated incidence of bleeding have fallen from 409/1000 women-years immediately after the first 12 months of amenorrhea following menopause to 42/1000 women-years more than three years after menopause(2,3).
The common etiology including:
●Endometrial hyperplasia: Endometrial hyperplasia may manifest clinically as uterine bleeding. Since premenopausal women should be estrogen deficient, endometrial hyperplasia at this time is abnormal and requires an explanation(4).
●Polyps: Polyps are benign endometrial growths of unknown etiology that are common cause of premenopausal and early premenopausal uterine bleeding(4).
●Leiomyomatauteri :Leiomyomata uteri (fibroids) are the most common pelvic tumors in women. The prevalence in premenopausal women is one-tenth that of premenopausal women, thus they are a potential but uncommon cause of uterine bleeding in menopausal women(5).
●Adenomyosis :Adenomyosis is a benign histologic finding of the uterus in which endometrial glands are infiltrating the myometrial wall. It can cause pain and menorrhagia during the reproductive years(6).
●Infection: Endometritis is an uncommon cause of premenopausal bleeding. In developing world endometrial tuberculosis may present as premenopausal bleeding(7).
●Cancer:The incidence of cancer as a cause of uterine bleeding increases with increasing age and adenocarcinoma of the endometrium is the most common genital cancer in women over 45 years of age(8).
●Anticoagulant therapy: Use of anticoagulants may cause uterine bleeding(9).
●Herbal and dietary supplements : Soy and other phytoestrogens in large doses may be associated withstimulation of the endometrial lining(9).
●Disease in adjacent organ : Inflammation of neighboring organs such as diverticulitis can cause inflammation of female upper genital tract. Rupture sigmoid diverticulum may fistulize into the uterus and present as uterine bleeding(10).
Aim Of The Work
Evaluate infection as an etiological factor of dysfunction bleeding women inFayoumgovernorate and the effect of antimicrobial treatment in proven dysfunctional uterine bleeding.
Mechanism of normal menstruation
The seat of normal menstrual bleeding is located in the upper two-thirds of the endometrialmucosa. It is characterized by tissue necrosis, disruption of microvasculature, migratory leukocytes and platelet/fibrin thrombi in microvessels.In the first half of the secretory phase of the menstrual cycle, acid phosphatase and other potent lytic