What is Abnormal Uterine Bleeding? Common Causes & Symptoms
Every woman's menstrual cycle is unique, but when bleeding patterns suddenly change or become concerning, it can be both physically uncomfortable and emotionally distressing. Abnormal uterine bleeding (AUB) affects millions of women worldwide and is one of the most common reasons for gynaecological consultations.
This blog takes a closer look at AUB, what it is, the different patterns it can take, common causes behind the changes, and when it’s important to seek medical advice. We’ll also explore how doctors diagnose the condition, the treatment options available, and practical steps you can take to manage symptoms and protect your overall reproductive health.
What Is Abnormal Uterine Bleeding?
Abnormal uterine bleeding refers to any bleeding from the uterus that differs from a normal menstrual period in timing, amount, duration, or frequency.
Abnormal uterine bleeding encompasses various patterns of irregular menstrual bleeding. To understand what's abnormal, it's helpful to know what constitutes a normal menstrual cycle. A normal cycle lasts 21 to 35 days, with bleeding lasting 3 to 7 days and a flow that's manageable with regular menstrual products.
AUB can include:
Periods that are too heavy or too light
Irregular timing or spotting between periods
Bleeding that lasts longer or shorter than usual
Women of all ages can experience AUB, from adolescents to perimenopausal women, and treatment may vary depending on age, health, and reproductive goals.
Common Causes of Abnormal Uterine Bleeding
Understanding the potential causes of abnormal bleeding can help you have more informed discussions with your healthcare provider. The causes are diverse and can be broadly categorised into structural and non-structural factors. The causes include:
Hormonal Imbalances
Hormonal fluctuations can cause irregular periods. Your menstrual cycle is regulated by a delicate balance of different hormones. When this balance is disrupted, it can lead to irregular bleeding patterns.
Conditions that commonly cause hormone imbalances include:
Anovulation: A menstrual cycle in which the ovary does not release an egg, often causing irregular, missed, or abnormal periods.
Polycystic Ovary Syndrome (PCOS): This hormonal disorder affects approximately 8-12% of women of reproductive age and can cause irregular or absent periods.
Thyroid disorders: Both overactive and underactive thyroid conditions can disrupt menstrual patterns.
Stress: Physical or emotional stress can affect hormone production and menstrual regularity.
Perimenopause: The transition period before menopause often involves fluctuating hormone levels.
Structural Abnormalities
Physical changes within the reproductive system are another cause of bleeding. These structural issues include:
Uterine Fibroids: These non-cancerous growths in the uterine wall are extremely common, affecting up to 70% of women by age 50. Fibroids can cause heavy menstrual bleeding, prolonged periods, and bleeding between periods.
Endometriosis: This condition occurs when tissue similar to the uterine lining grows outside the uterus, often causing painful periods.
Polyps: Small growths on the inner wall of the uterus (endometrial polyps) or cervix can cause irregular vaginal bleeding, especially between periods.
Adenomyosis: This condition involves the uterine lining growing into the muscle wall of the uterus, typically causing heavy, painful periods.
Medications and Medical Devices
Certain medications and contraceptive methods can also cause abnormal bleeding patterns:
Birth control pills, patches, or rings
Intrauterine devices (IUDs)
Blood-thinning medications
Certain antidepressants or hormonal treatments
Other Medical Conditions
Various health conditions can cause abnormal uterine bleeding, including bleeding disorders, liver disease, kidney disease, and certain cancers.
Although hyperplasia or malignancy of uterus is relatively uncommon but still needs to be considered in all cases of AUB.
If you’re unsure what might be causing your abnormal bleeding, don’t leave it to guesswork. Book an appointment with us today and get clarity, guidance, and a personalised care plan.
Recognising the Symptoms of AUB
Heavy menstrual bleeding is one of the most recognisable symptoms of AUB, but the condition can present in various ways. Being aware of these different patterns can help you identify when to seek medical attention. The following are the symptoms of abnormal uterine bleeding:
Heavy Periods
Heavy menstrual bleeding is defined as excessive menstrual blood loss affecting woman’s physical, emotional, social and material quality of life.
Recognisable signs include:
Changing a pad or tampon every hour for several consecutive hours.
Using double protection (tampons and pads together).
Bleeding for more than seven days.
Passing blood clots larger than 50 cent size.
Flooding or gushing of blood.
Irregular Timing
Abnormal timing of menstrual bleeding can occur as:
Spotting between periods: Light bleeding or spotting that occurs outside your normal menstrual cycle.
Postmenopausal bleeding: Any bleeding that occurs after menopause requires immediate medical evaluation.
Frequent periods: Cycles shorter than 21 days.
Infrequent periods: Cycles longer than 35 days or missing periods entirely.
Duration Changes
Changes in how long your periods last can also indicate AUB:
Periods lasting longer than seven days.
Periods that are significantly shorter than usual.
Bleeding that stops and starts unpredictably.
Risk Factors for Abnormal Uterine Bleeding
Several factors can increase your likelihood of developing abnormal uterine bleeding. Understanding these risk factors can help you and your healthcare provider assess your situation.
Age-Related Factors
Adolescence: Young women who have recently started menstruation bleeding may experience irregular cycles as their hormonal systems mature.
Reproductive years: Women in their 20s, 30s, and early 40s may develop AUB due to various structural or hormonal causes.
Perimenopause: Women approaching menopause often experience irregular bleeding as hormone levels fluctuate.
Lifestyle Factors
Obesity: Excess weight can affect hormone production and increase the risk of certain conditions like PCOS.
Extreme weight loss or gain: Rapid weight changes can disrupt hormonal balance.
Excessive exercise: Intense athletic training can affect menstrual regularity.
Stress: Chronic physical or emotional stress can impact hormonal systems.
Medical History
Previous reproductive health issues: History of ovarian cysts, endometriosis, or other gynaecological conditions.
Family history: Genetic predisposition to certain conditions, like bleeding disorders or reproductive cancers.
Chronic medical conditions: Diabetes, thyroid disorders, or autoimmune conditions.
Having one or more risk factors doesn’t always mean you will develop abnormal bleeding, but it’s a good reason to stay proactive. Enquire with us today to discuss your health.
Diagnosing Abnormal Uterine Bleeding
To identify the underlying cause, doctors often use a combination of tests, including:
Ultrasound: To examine the uterus, ovaries, and endometrium.
Blood test: To assess hormone levels, clotting function, and thyroid health.
Blood count: To check for anaemia from heavy bleeding
Iron studies: To check for iron deficiency
Endometrial biopsy: In some cases, a small sample of the uterine lining is tested to rule out cancer or pre-cancerous changes.
When to See a Doctor
While some menstrual irregularities can be normal, certain symptoms require prompt medical attention. Knowing when to seek help can prevent complications and ensure you receive appropriate care.
Seek Immediate Medical Care If You Experience:
Severe bleeding: Soaking through a pad or tampon every hour for more than two hours.
Signs of severe anaemia: Extreme fatigue, shortness of breath, dizziness, or fainting.
Severe pelvic pain: not relieved with simple pain relief
Any bleeding after menopause: This always requires urgent evaluation to rule out serious conditions.
Schedule an Appointment Soon with Dr. Priyanka If You Have:
Periods lasting longer than seven days.
Cycles shorter than 21 days or longer than 35 days.
Bleeding between periods.
Periods that are significantly heavier than normal for you.
Missing periods when you're not pregnant.
Postmenopausal bleeding
Don't hesitate to contact us if you're concerned about any changes in your menstrual pattern. Early evaluation and treatment can prevent complications and improve your quality of life.
Treatment Options for Abnormal Uterine Bleeding
Treatment for abnormal uterine bleeding varies significantly based on the underlying cause, your age, symptom severity, and reproductive goals. The good news is that there are numerous effective options available, ranging from medications to surgical procedures.
Medical Treatments
Hormonal Therapies:
Combined oral contraceptives: Birth control pills can regulate cycles and reduce heavy bleeding.
Progestin therapy: Available as pills, injections, or intrauterine devices.
GnRH agonists: These medications temporarily stop menstruation and can be used before surgery.
Non-Hormonal Medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Can reduce bleeding and associated pain.
Tranexamic acid: A medication that helps blood to clot and can significantly reduce heavy menstrual bleeding.
Iron supplements: Important for treating anaemia caused by excessive bleeding.
Surgical Options
When medical treatments aren't effective or appropriate, surgical interventions may be considered:
Minimally Invasive Procedures:
Endometrial ablation: This procedure destroys the uterine lining to reduce or stop bleeding.
Uterine artery embolisation: Blocks blood supply to fibroids, causing them to shrink.
Myomectomy: Surgical removal of fibroids while preserving the uterus.
Hysterectomy: This major surgical procedure involves removing the uterus and is typically considered when other treatments have failed or when there are serious underlying conditions. It's a permanent solution that eliminates menstrual bleeding entirely but also ends fertility.
Prevention and Management Tips
While not all causes of AUB can be prevented, you can manage symptoms with simple steps:
Maintain a healthy lifestyle: Keep a balanced diet, regular exercise, and adequate sleep to support hormonal balance.
Manage stress: Try mindfulness, meditation, or counselling if needed.
Track your cycles: Note timing, flow, and symptoms to share with your doctor.
Manage heavy bleeding: Use suitable menstrual products, stay hydrated, rest, and address the causes with your doctor.
Regular check-ups: Visit a gynaecologist periodically and discuss any menstrual changes.
Conclusion
Abnormal uterine bleeding is a common condition that affects many women, but it doesn't have to control your life. With proper understanding, appropriate medical care, and effective treatment, most women can find significant relief from their symptoms.
Remember that every woman's experience with AUB is unique. What works for one person may not be the best approach for another. The most important step is to work with an Obstetrician and Gynaecologist who listens to your concerns and develops a personalised treatment plan based on your specific situation and goals.
If you’re living with abnormal uterine bleeding, know that you don’t have to manage it alone. Book a consultation with us today and take the first step toward better reproductive health.
The content provided in this blog is for informational and educational purposes only and is not intended as medical, legal, or professional advice. While we strive to provide accurate and up-to-date information, it should not replace consultation with a qualified professional. Always seek the advice of a licensed healthcare provider or Dr. Priyanka Karine regarding any questions or concerns you may have.