الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Dysfunctional uterine bleeding (D.U.B.) is an abnormal uterine bleeding in absence of an obvious organic cause, it is not associated with pregnancy, inflammation or tumor. DUB is a disease which is diagnosed by exclusion. It is classified into primary and secondary:
Primary D.U.B; is defined as a dysfunction in hypothalamo-pituitary. Ovarian axis.Secondary D.U.B; may be due to systemic disorders as hypothyroidism, clotting dysfunction, iatrogenic causes as intra uterine contraceptive device and hormonal contraception. Medical treatment is the usual first line approach; non steroidal anti inflammatory drugs such as mefenamic acid or antifibrinolytic agents such as tranexamic acid will reduce blood loss by 25-50%. The combined oral contraceptive pills may reduce blood loss by 50%. Cyclical progestins such as norethisterone decreases MBL by 80%. They have been widely used for the treatment of anovulatory cycles. Medications which suppress ovarian function such as danazol or gonadotrophin releasing hormone analogues are highly effective in inhibiting menstrual blood loss but they cause amenorrhea in more than 50%.
Progestogen releasing intra uterine system reduces menstrual blood loss by 90%. It’s an effective treatment for menorrhagia and may be used as an alternative to hysterectomy. Itreleases levonorgestrel which causes atrophy of endometrial glands and it may also inhibits ovulation.If medical treatment fails, hysterectomy should be considered, though less invasive surgical methods of endometrial ablation are being developed and proved to be very effective in treatment of menorrhagia with success rate ranging from 70 – 97%. Hysterectomy is sometimes necessary to cure women with menorrhagia, but it may be inappropriate in younger women and unnecessary in women near menopause
Indomethacin releasing intra uterine device developed recently for treatment of dysfunctional uterine bleeding without hysterectomy proved to be highly effective. It releases indomethacin intrauterine which inhibits the generationofprostaglandins and lightens the endometrial impairment caused by IUD. It is also an effective contraceptive method and reduces yspareunia as it contains no threads. It’s also very cheap and economic.This study was undertaken to evaluate the efficacy and safety of thermal balloon ablation versus indomethacin medicated copper intrauterine device fortreatment of dysfunctionalmenorrhagia.ThisProspective comparative study carried out at Benha Univeristy hospital Departement of Obstetrics and Gynecology for females with dysfunctional menorrhagia at the age ranging (40- 49) years old and during the period from January 2012 to in July 2014.Accordingly, indications, contraindications, patient selection, counseling and preparation were thoroughly and comprehensively reviewed.
The study includedsixtypatientspresenting with menorrhagia. They were divided into two groups: