The majority of cases of DUB occur in the 5-10 years before the menopause or after the menarche, when the ovaries are in an unstable responsive state. Hormonal dysfunction is responsible for most cases of DUB and the condition will usually respond to appropriate hormonal therapy. In those instances where hormones are not a viable option or have not controlled the problem, then prostaglandin inhibitors or the use of tranexamic acid may allow short term relief from excessive bleeding. Surgery by endometrial ablation of hysterectomy should only be considered when all other options have failed.