Abnormal Uterine Bleeding

Abnormal uterine bleeding is classified as any bleeding that occurs between regular menstrual periods. In some cases, abnormal uterine bleeding occurs after intercourse, or in women who are postmenopausal. Heavier-than-normal menstrual bleeding that lasts for more than seven days is considered abnormal uterine bleeding.

Causes of Abnormal Uterine Bleeding

Abnormal uterine bleeding has many possible causes. In some cases, birth control methods, including birth control pills or intrauterine devices (IUDs), can cause spotting or heavy periods. Additional causes of abnormal uterine bleeding include the following:

  • Abnormal growths
  • Pregnancy
  • Miscarriage
  • Polycystic ovary syndrome
  • Pelvic inflammatory disease
  • Uterine fibroids
  • Polyps
  • Infection
  • Cervical cancer
  • Uterine cancer
  • Vaginal cancer

Abnormal uterine bleeding can also be caused by abnormal hormone levels. Often the result of high estrogen levels that are not balanced by an appropriate level of progesterone, they can prevent an egg from being released, or thicken the uterine lining and cause it to shed irregularly. Chronic medical conditions, such as thyroid disorders and diabetes, can also lead to abnormal uterine bleeding.

Diagnosis of Abnormal Uterine Bleeding

Abnormal uterine bleeding is diagnosed through a physical examination and an evaluation of the patient's medical history, including the frequency and length of menstrual periods. A pregnancy test may also be administered. Additional tests may include the following:

  • Sonohysterography
  • Blood tests
  • Endometrial biopsy
  • Hysteroscopy

An ultrasound or MRI scan, which will provide images of the uterus and internal organs, may also be performed.

Treatment of Abnormal Uterine Bleeding

Treatment for abnormal uterine bleeding varies, depending on its cause. Treatment methods may include the following:

  • Hormone supplements
  • Antibiotics to treat infection
  • Removal of an IUD
  • Birth control pills to regulate periods
  • Nonsteroidal anti-inflammatory medication

Surgery may be necessary to remove growths such as polyps or fibroids that can cause bleeding. Several other types of surgery may be performed to treat abnormal uterine bleeding.

Endometrial Ablation

Endometrial ablation is a procedure that destroys a layer of the lining of the uterus to stop bleeding. In some cases, it means the cessation of menstruation; in others, it means a reduction in menstrual blood flow to lighter or normal levels. Pregnancy following endometrial ablation is unlikely; a woman who wants to become pregnant should not have the procedure.

Hysterectomy

In severe cases, if other treatment methods have not been successful, hysterectomy, which removes the entire uterus, may be recommended. Hysterectomy requires a hospital stay, and then an at-home recovery period of 6 to 8 weeks.

Abnormal uterine bleeding caused by a miscarriage requires prompt medical attention to prevent serious complications.

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