Gynaecology is the medical speciality concerned with medical and surgical conditions of the female reproductive system  (except from those related to pregnancy and child-birth – that is obstectrics). The female reproductive system comprises  the ovaries, the fallopian tubes, the uterus and the vagina. Conditions of the female urinary tract may be treated by Pathological conditions in the female reproductive system can be structural (uterine fibroids, cervix cancer etc.) or functional – where abnormal findings can not be identified. This is exactly characterising Dysfunctional Uterine Bleeding (DUB), a condition where no cause can be identified but the heavy periods impairs the quality of life substantially.Heavy menstrual bleeding is group of conditions characterised by heavy periods: half of them have underlying malformations such as fibroids, polyps adenomyosis and other. Another half is DUB – Dysfunctional Uterine Bleeding. In general, heavy menstrual bleeding is not a rare disorder and is involved in 25% in gynaecological surgeries[1].

DUB is mostly caused by altered hormonal cycles: unbalanced fluctuation of hormonal levels results in overgrowth of the uterine lining. This results in tendency to bleed profusely during the periods and leads to anaemia. Less common cause of DUB is due to specific blood coagulation deficiencies such as Von Willebrand disease. 

Physiology
The female reproductive organs are regulated by the female sexual hormones, substances-messengers managing the development of the genitals in childhood and functioning of those in adult age.

In the fertile age the general levels of hormones remain high assuring the proper functioning of the reproductive system. However, the levels do not remain steady but swing periodically causing menstrual cycle and female periods. The menstrual cycle starts with menstruation were the uterine lining is shed – menstruation normally takes 3-5 days. Afterwards it takes 8 – 9 days (so-called follicular phase) until the new lining is restored in uterus and the egg is released from ovary – so-called ovulation takes place. The uterine lining is then mature and ready for implantation of egg. If implantation does not occur during the following 13-14 days (so-called luteal phase) the endometrium is shed thus starting the new cycle.

During pregnancy the hormonal levels are increasing dramatically losing cyclic fluctuation. The menstrual cycle stops and the hormonal stimulation makes uterus grow together with the fetus. The cyclic physiology is restored after delivery.