Abnormal uterine bleeding (AUB) is any heavy or unusual bleeding from the uterus (through your vagina). It can either be bleeding between monthly periods, prolonged bleeding, or an extremely heavy flow. Also, it can occur at any time during your monthly cycle.
AUB can occur:
- As spotting or bleeding between your periods
- After sex
- For longer days than normal
- Heavier than normal
- After menopause
Bleeding during pregnancy is a different problem. If you are pregnant and have any amount of bleeding from the vagina, inform your doctor.
What causes abnormal uterine bleeding?
There are many causes of abnormal uterine bleeding. Early pregnancy is a common cause. Uterine cancer or cervical cancer is an important cause as well. Fibroids or polyps in the uterus can also cause bleeding. In addition, hormonal changes such as during menopause. Moreover, in some cases, no one knows what causes it. Hormonal birth control such as birth control pills also increases your risk.
These are just a few of the problems that can cause abnormal uterine bleeding. These problems can occur at any age, but the likely cause of abnormal uterine bleeding usually depends on your age.
What are the symptoms?
Abnormal uterine bleeding is unpredictable. The bleeding may be very heavy or light and can occur often or randomly. You may have abnormal uterine bleeding if you have one or more of the following symptoms:
- Vaginal bleeding between periods
- Bleeding that lasts for more days than 7 days
- You get your period more often than every 21 days or farther apart than 35 days. A normal adult menstrual cycle is 21 to 35 days long. A normal teen cycle is 21 to 45 days.
- Time between periods changes each month
- Passing blood clots and soaking through your usual pads or tampons each hour for 2 or more hours.
If you feel tired or fatigue, it means you loss too much blood over time. This is a symptom of anemia. Also, inform your doctor if bleeding is severe.
How is abnormal uterine bleeding diagnosed?
Your doctor will ask you what brings on the bleeding. He or she will ask about any other symptoms you might be having. After that, there will be a physical exam. This will include a pelvic exam, exam of the cervix, and possibly a Pap smear.
In addition, your doctor may order some tests which depend on your age. If you could be pregnant, your doctor may order a pregnancy test. This is to make sure it’s not vaginal bleeding from pregnancy or miscarriage.
Besides, blood tests to check how your blood clots. Also an ultrasound. Blood count to make sure you don’t have a low blood count from the blood loss. He or she may also take a tiny sample (biopsy) of tissue from your uterus for testing. The test will show if you have cancer or a change in the cells.
What is the treatment for abnormal uterine bleeding?
There are several treatment options for abnormal bleeding. Your treatment will depend on the cause of your bleeding, your age, and whether you want to get pregnant in the future. Your doctor will help you decide which treatment is right for you. Each treatment works for some women but not others. Treatments include:
Birth control pills
They can control your periods. They can also slow the growth of the endometrium. Progestin alone can prevent very heavy bleeding in women who do not ovulate the same each month. It can also be given by a shot, implant.
Intrauterine device (IUD)
Your doctor may suggest an IUD. An IUD is a small, plastic device that your doctor inserts into your uterus through your vagina to prevent pregnancy. IUD releases hormones which can significantly reduce abnormal bleeding. Like birth control pills, sometimes IUDs can actually cause abnormal bleeding. Tell your doctor if this happens to you.
You might need surgery to get rid of uterine fibroids and polyps. One option for getting rid of fibroids is called uterine artery embolization. With this, the fibroids’ blood supply is cut off. This is by putting tiny particles into the uterine arteries. This makes the fibroids shrink. Uterine fibroids can also be removed surgically, while keeping the uterus and the ability to have children. This is called a myomectomy.
Surgery to destroy the lining of the uterus, called uterine ablation. This may be an option for some women. With this, the lining of the uterus is destroyed through the use of a laser, heat, electricity, microwave energy, or freezing.
Finally, hysterectomy. This type of surgery removes the uterus. If you have a hysterectomy, you won’t have any more periods and you won’t be able to get pregnant.
Abnormal uterine bleeding can impact your life in a negative way. Also, heavy menstrual bleeding may limit your daily activities during your period. You should make sure that you are getting enough iron in your diet.
If you have heavy menstrual bleeding, try taking ibuprofen (Advil, Motrin) during your period. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can work to reduce the bleeding during your period.