Abnormal Uterine Bleeding
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
Copyright © November 1999 The American College of Obstetricians and Gynecologists
The menstrual period is the time during a woman’s cycle when bleeding occurs. Bleeding may last up to seven days. When the menstrual cycle is not regular, bleeding lasts longer or is heavier than normal, or bleeding occurs between periods, it is known as abnormal uterine bleeding.The Menstrual Cycle
The menstrual period begins with the first day of the bleeding of one period and ends with the first day of the next period. An average menstrual cycle lasts about 28 days.
Causes of Abnormal Uterine Bleeding
It is normal for menstrual periods to be irregular at certain times of life. For the first few years after a girl begins to have periods (around age 9 to 16), they are often irregular. As women approach menopause (around the age of 50), their periods once again may become irregular.
Menstrual cycles that are longer than every 35 days (bleeding too seldom) or shorter than every 21 days (bleeding too often) are not normal. Women with such cycles should be checked by a doctor.
Abnormal or heavy uterine bleeding may occur because of hormonal problems.
The most common result of a hormone imbalance is anovulation — when the ovaries do not release an egg and a woman does not have a period.
Anovulation may occur if the ovaries produce too much androgen — a male hormone. Often, when anovulation occurs, the ovaries develop many cysts. This condition is known as polycystic ovary syndrome.
Symptoms of polycystic ovary syndrome include:
- Irregular uterine bleeding
- Irregular periods from an early age
- Infertility
- Acne
- Excessive facial hair or hair on the abdomen or chest
Diagnosis
To diagnose abnormal uterine bleeding, your doctor will obtain a history of your health. It is helpful for you to keep track of the dates and length of your periods by marking them on a calendar.
Your doctor also will do a physical exam. You may have blood tests to check your blood count and hormone levels and to see if you are pregnant. Other tests may be needed based on your symptoms.
Treatment
Treatment for abnormal uterine bleeding will depend on the cause.
Hormone Therapy
Your doctor may prescribe hormones, such as birth control pills, progesterone or thyroid medication. These hormones will cause your periods to be more regular and may improve other symptoms.
After a few menstrual cycles, your doctor should be able to judge how well treatment is working.
Other Medications
Some medications, such as antiinflammatory drugs (for instance, ibuprofen), may be helpful for heavy bleeding. They also may be used to relieve menstrual cramps. If you have an infection, you will be given antibiotics.
Surgery
Some women with abnormal uterine bleeding will have surgery to remove growths (such as polyps or fibroids) that are causing the bleeding.
Endometrial ablation is another method for treating abnormal uterine bleeding.
Hysterectomy — removal of the uterus — also may be used to treat abnormal uterine bleeding.
Hysterectomy and endometrial ablation are both major surgeries.
Finally …
If you notice that your cycles have become irregular, you should see your doctor. Abnormal uterine bleeding has a number of causes. There is no way of telling why your bleeding is abnormal until your doctor examines you. Once the cause is found, abnormal uterine bleeding often can be treated with success.