What is the prevalence of AUB in perimenopausal women?

• A. Over 90%
• B. About 20%
• C. <5%
• D. Up to 50%

Answer: (D)

In perimenopause, hormonal fluctuations become unpredictable as ovarian function declines, leading to irregular or absent ovulation. When ovulation is inconsistent, the endometrium receives uneven levels of progesterone, which causes erratic, sometimes heavy or prolonged bleeding. This pattern makes abnormal uterine bleeding a common complaint during the perimenopausal transition. The best estimate is that up to about half of perimenopausal women experience AUB at some point during this period, reflecting the high but not universal prevalence. Estimates can vary depending on how AUB is defined and the specific population studied, but the idea that AUB is common in this life stage is well supported.