Abnormal Uterine Bleeding

Understanding normal menstrual cycles

The typical menstrual cycle spans 21 to 35 days, with a regular period lasting up to 7 days.   Note: This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Telehealth consultations are not suitable for physical pelvic examinations. Diagnosis of abnormal bleeding typically requires physical assessment, ultrasound, and sometimes biopsy. If you have severe bleeding causing dizziness or fainting, call 000. We recommend sharing your consult summaries with your regular GP bulk billing is available for eligible patients during Medicare-defined periods; otherwise, private fees apply.  

Identifying abnormal bleeding

Bleeding is considered abnormal under various circumstances, such as:

• Bleeding or spotting between periods
• Bleeding or spotting after intercourse
• Heavy bleeding during menstruation
• Bleeding that saturates one or more tampons or pads every hour
• Menstrual cycles longer than 35 days or shorter than 21 days
• Irregular periods with cycle length variations exceeding 7 to 9 days
• Absence of a period for 3 to 6 months
• Postmenopausal bleeding

Differentiating between chronic and acute abnormal uterine bleeding

Abnormal uterine bleeding can manifest as a chronic condition, persisting for at least six months. Alternatively, sudden and severe episodes are termed acute abnormal uterine bleeding. Acute abnormal uterine bleeding can lead to severe blood loss. Do NOT use telehealth if you experience these symptoms. Call 000 or go to the Emergency Department immediately if you have:

• Heavy bleeding soaking more than one pad/tampon per hour for two hours.
• Chest pain or shortness of breath.
• Light-headedness, dizziness, or fainting.

Common ages for abnormal bleeding

While abnormal bleeding can occur at any age, irregular periods are typical during the onset of menstruation (around age 9 to 14) and during perimenopause (around age 50).

Causes of abnormal bleeding

Several factors contribute to abnormal uterine bleeding, including:

• Ovulation issues
• Fibroids and polyps
• Adenomyosis
• Bleeding disorders
• Medications
• Other causes like endometriosis, pregnancy-related issues, and pelvic inflammatory disease.

Diagnosis of abnormal bleeding

To diagnose abnormal bleeding, your ob-gyn will consider your health history, conduct a physical and pelvic exam, and may perform lab tests. Additional radiology tests may include ultrasound, hysteroscopy, endometrial biopsy, and sono-hysterography.

Medications for controlling abnormal bleeding

Various medications can help manage irregular or heavy menstrual bleeding, including hormonal birth control methods, progestin-only options, hormone therapy, GnRH agonists, tranexamic acid, NSAIDs, and clotting medications for bleeding disorders or antibiotics for infections.

Surgical interventions for abnormal bleeding

If medications are ineffective, surgical options may be considered, such as:

• Endometrial ablation
• Fibroid treatments (uterine artery embolization, ultrasound surgery, myomectomy)
• Hysterectomy (removal of the uterus) - performed through the vagina, abdomen, or laparoscopy.

This content is shared with the permission of Dr. Baruah. You may find similar information in health publications.

How Hola Health may be able to help

Hola Health is an Australian telehealth platform that connects you with registered doctors and nurse practitioners - from the comfort of your home, at a time that suits you. Depending on your situation, a Hola Health clinician may be able to help with:

• 24/7 General medical advice via telehealth doctor consult - talk through symptoms or health concerns with a registered doctor or medical practitioner.
• Medical certificate online - for work or personal leave, when clinically appropriate
• Referrals to specialists - or in-person services when needed
• Online prescriptions - at a clinician's discretion and where clinically suitable.
• Pathology or imaging requests - when assessed as appropriate by your treating clinician.
• Mental health Care Plan - Mental Health Treatment Plans (referral to your regular GP may be recommended for ongoing care).

Hola Health clinicians are AHPRA-registered Doctors and medical practitioners in Australia. They will always recommend an in-person consultation, specialist referral, or emergency care if that is in your best interest.

Note: Telehealth is not suitable for all conditions. Hola Health does not replace your regular GP, specialist, or emergency services. If you are unsure whether telehealth is right for your situation, we recommend speaking with your usual healthcare provider. In emergencies, call 000.