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Dr.'s Blog

 

Abnormal Uterine Bleeding

Robert F. Lemert MD FACOG
Celebration Obstetrics and Gynecology

Abnormal uterine bleeding (AUB) can be a frustrating gynecological condition for a woman to face. It often comes on gradually, getting worse and worse until medical advice is sought.

A woman's normal menstruation cycle involves a complex series of hormonal events that involve many different areas of the body. A normal interval between menstrual cycles is considered to be 28 days plus or minus 7 days. The normal duration of flow is between 2 and 7 days.

Menorrhagia (excessive bleeding) is most commonly caused by anovulatory menstrual cycles. Occasionally it is caused by thyroid dysfunction, infections or cancer.

It is normal for menstrual periods to be irregular at certain times of life. In puberty, when a girl begins to have periods, they are often irregular. As menopause approachs, their periods once again may become irregular. Menstrual cycles that are longer than every 35 days or shorter than every 21 days are not normal. Women with such cycles should be evaluated.

AUB can be divided into anatomic and dysfunctional causes. Anatomic causes are processes such as genital lesions and diseases of the female genital tract that may cause bleeding. AUB is caused by the loss of coordination of the complex hormonal events involved in the menstrual cycle. This is when the ovaries do not release an egg and a woman does not have a period. This bleeding is related to irregularities of a woman's menstrual cycle without any evidence of disease; this is a diagnosis of exclusion, which means that all other causes for the bleeding including trauma, lesions, or diseases have been looked for and determined not to be the cause of the bleeding. The different reasons that a woman would have AUB vary according to her age.

To diagnose AUB, your doctor will obtain a history of your health. Your doctor also will do a physical exam. You may need blood tests based on your symptoms.

Treatment for AUB will depend on the cause. Your doctor may prescribe hormones. These hormones will cause your periods to be more regular and improve other symptoms. Some medications, like Aleve, may be helpful for heavy bleeding and menstrual cramps. Some women will have surgery to remove growths (such as polyps or fibroids) that are causing the bleeding. Endometrial ablation is a method for treating AUB. Definitive treatments, like hysterectomy, may be used to treat AUB.

If you notice that your cycles have become irregular, you should consult your doctor. There are a number of causes for abnormal uterine bleeding. There is no way of telling why your bleeding is abnormal until you have been examined. Once the cause is found, abnormal uterine bleeding often can be treated with success.

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