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.

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. Seek emergency medical attention for acute episodes involving heavy bleeding, chest pain, shortness of breath, light-headedness, or dizziness.

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
• Cancer
• 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 tests may include ultrasound, hysteroscopy, endometrial biopsy, sono-hysterography, MRI, and CT scans.

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, MRI-guided 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.