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Understanding Abnormal Uterine Bleeding: Symptoms, Causes, Diagnosis, and Treatment

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.

Symptoms of Abnormal Uterine Bleeding

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

Understanding Abnormal Uterine Bleeding: Symptoms, Causes, Diagnosis, and Treatment

Causes of Abnormal Uterine Bleeding

There are several potential causes of abnormal uterine bleeding, including:

Hormonal Imbalances

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)

Uterine Abnormalities

Physical problems with the uterus can also cause abnormal bleeding, such as:

  • Uterine fibroids

  • Polyps

  • Adenomyosis

  • Endometriosis

Other Health Conditions

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

Diagnosing Abnormal Uterine Bleeding

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 Options for Abnormal Uterine Bleeding

Treatment for abnormal uterine bleeding will depend on the underlying cause and your individual circumstances. Options may include:

Medications

  • 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

Procedures

  • 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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