Abnormal Uterine Bleeding

Abnormal Uterine Bleeding is any heavy or unusual bleeding from the uterus. It can occur at any time during the monthly menstrual cycle, including during the normal menstrual period.

Symptoms of abnormal bleeding include

  • spotting or bleeding in between the regular cycle,
  • very heavy bleed during the period (menorrhagia),
  • periods lasting more than 7 days (polymenorrhea),
  • irregular periods (metrorrhagia),
  • bleeding occurring after menopause

The causes of abnormal bleeding in women vary with age. While in the younger population (teenagers, 20’s and 30’s), hormonal imbalances and pregnancy account for the majority of the cases, as age advances, cancer becomes the primary suspect for abnormal bleeding. Hormone replacement therapy for post-menopausal women is another significant cause for menstrual bleed. In women with suspected uterine cancer/cervical cancer, abnormal bleeding can be an indicator of underlying disease and must be treated with great importance. Sometimes, benign conditions such as a cervical polyp may also bleed and give rise to spotting in between normal menstrual cycle.

Dysfunctional uterine bleeding (DUB) is another sub category of abnormal uterine bleeding which presents with the same symptom profile. It is caused exclusively due to a hormonal imbalance in the absence of any structural anomaly. As such, it is a diagnosis of exclusion.

Treatment options for abnormal uterine bleeding depend on the cause of the bleed. While there is no way to prevent abnormal bleeding, if it is caused due to hormonal imbalance and you are overweight, regular exercise and weight loss may help to alleviate symptoms. Birth control pills and IUDs, hormone patches, dilatation and curettage, endometrial ablation, polypectomy and as a last resort, hysterectomy especially in older women is some modalities to treat patients with abnormal uterine bleeding.