Background: Abnormal uterine bleeding (AUB) is one of the most common gynecological complaints affecting women of reproductive and perimenopausal age. It significantly impacts quality of life, physical health, and psychological well being. Both medical and surgical modalities are available for management; however, the choice of treatment depends on symptom severity, patient preference, age, parity, and associated pathology.

Aim: To compare the clinical outcomes of medical versus surgical management in women with abnormal uterine bleeding.

Materials and Methods: This prospective comparative observational study was conducted in the Department of Obstetrics and Gynecology, Sree Mookambika Institute of Medical Sciences over a period of one year. A total of 60 women diagnosed with AUB were included in the study, with 30 patients each in the medical and surgical management groups. Detailed history, clinical examination, laboratory investigations, and ultrasonography were performed in all participants. Patients were followed up for six months to assess symptom relief, improvement in hemoglobin levels, patient satisfaction, complications, and need for repeat intervention. Statistical analysis was performed using SPSS software, and a p-value <0.05 was considered statistically significant.

Results: Heavy menstrual bleeding was the most common presenting complaint (63.3%). Surgical management demonstrated significantly greater improvement in hemoglobin levels (2.9 ± 1.0 g/dL) compared to medical management (1.5 ± 0.8 g/dL) (p<0.001). Complete symptom relief was observed in 83.3% of surgically treated patients and 56.7% of medically managed patients. Patient satisfaction was higher in the surgical group (90%) than in the medical group (70%). However, postoperative complications and longer hospital stay were more common in the surgical group.

Conclusion: Surgical management provided superior symptomatic relief and patient satisfaction compared to medical therapy in women with AUB, though it was associated with increased morbidity and hospitalization. Individualized treatment selection remains essential for optimal patient outcomes.

KEYWORDS: Abnormal Uterine Bleeding, Medical Management, Surgical Management, Hysterectomy, Menorrhagia, Quality of Life, Gynecology.