Abnormal uterine bleeding (AUB) is a condition where you experience bleeding outside of your normal monthly period. This can include heavy periods, irregular periods, or bleeding between periods. While there is a wide range of what is considered normal for menstrual cycles, if your period is so heavy or unpredictable that it interferes with your daily life, it may be a sign of an underlying medical condition that requires treatment.
The signs and symptoms of abnormal uterine bleeding can vary from person to person, but may include:
Heavy periods that require changing pads or tampons more than once per hour
Periods that last longer than 7 days
Bleeding between periods or after sex
Irregular periods that vary in length or frequency
Bleeding after menopause
There are several potential causes of abnormal uterine bleeding, including:
Hormonal imbalances are the most common cause of AUB. Factors that can disrupt hormone levels include:
Puberty and menopause
Birth control pills and other medications
Rapid weight changes
Stress
Polycystic ovary syndrome (PCOS)
Physical problems with the uterus can also cause abnormal bleeding, such as:
Uterine fibroids
Polyps
Adenomyosis
Endometriosis
In rare cases, AUB may be a symptom of a more serious health condition, such as:
Cervical, endometrial, or uterine cancer
Kidney, liver, thyroid, or adrenal gland disorders
Sexually transmitted infections
To diagnose the cause of your abnormal uterine bleeding, your doctor will likely start by asking about your symptoms and medical history. They may also perform a physical exam and order tests such as:
Blood tests to check for anemia, hormone levels, and other health conditions
Ultrasound to examine the uterus for fibroids or polyps
Hysteroscopy to view the inside of the uterus
Biopsy to test for abnormal cells
MRI to detect adenomyosis
Treatment for abnormal uterine bleeding will depend on the underlying cause and your individual circumstances. Options may include:
Hormonal birth control to regulate menstrual cycles
Gonadotropin-releasing hormone agonists or antagonists to control heavy bleeding
Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce bleeding
Tranexamic acid to promote blood clotting
Endometrial ablation to destroy the uterine lining
Myomectomy or uterine artery embolization to remove or shrink fibroids
Hysterectomy to remove the uterus (typically a last resort)
If left untreated, abnormal uterine bleeding can lead to complications such as anemia and difficulty getting pregnant. If you are experiencing symptoms of AUB, it is important to speak with your healthcare provider to determine the cause and appropriate treatment plan.
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