Abstract

Abnormal uterine bleeding (AUB) is a common gynecologic disorder, especially among women with underlying bleeding disorders. AUB has a significant negative impact on women’s quality of life, physical health, and hematologic status. Different medical and surgical management choices are available; however, there is a gap in reporting evidence-based decision-making. The current systematic review aimed to combine the available studies on the efficacy of available treatment options for AUB. This systematic review was conducted among studies published between 2000 and 2025, depending on the PRISMA criteria. The data collection focused on patient demographics, treatment methods, bleeding outcomes (including PBAC scores), amenorrhea, quality-of-life metrics, and blood parameters. The systematic review was conducted among nine studies of different populations and management strategies. Levonorgestrel 52 mg intrauterine device showed steady effectiveness with significant reduction of menstrual blood loss, high amenorrhea rates, and better quality of life. In addition, desmopressin and other hemostatic treatments also showed a good reduction of bleeding intensity. Octreotide was linked with bleeding improvement in certain cases; endometrial ablation provided nearly total bleeding control and higher hemoglobin levels in intractable patients. Among wider populations, hormonal therapies were linked to better outcomes and a decreased incidence of anemia. Managing aberrant uterine hemorrhage based on evidence calls for a tailored approach guided by patient characteristics, etiology, and treatment objectives. While hemostatic, antifibrinolytic, and surgical treatments offered useful choices for certain patients, the levonorgestrel intrauterine device came to be the most effective and thorough solution across a variety of outcomes.

Key words: Evidence-based approaches, abnormal uterine bleeding, systematic review, management options