Between-cycle bleeding, prolonged bleeding, or an exceptionally heavy period are all examples of abnormal uterine bleeding. Fibroids, polyps, hormonal abnormalities, and – in rare instances — malignancy are examples of potential causes.

AUB can happen:

• comparable to spotting or bleeding in between cycles
• For longer than usual days after having sex
• greater than usual
• following menopause
• It doesn't happen while pregnant. Pregnancy bleeding can have a variety of causes. Be cautious about calling your doctor if you experience any bleeding while expecting.

What is abnormal uterine bleeding (menometrorrhagia)?

You have abnormal uterine bleeding when you bleed outside of your monthly period or when your menstruation is exceptionally heavy. Every 21 to 35 days, women will usually experience their monthly period, which lasts about five days.

What is the difference between menorrhagia and menometrorrhagia?

Menometrorrhagia used to be a catch-all word for two different but similar-sounding conditions:

Menstruating too much or for a long time is known as menorrhagia.

Metrorrhagia is heavy, irregular, and prolonged bleeding unrelated to menstruation.

To avoid confusion, the names were modified in 2011 by the International Federation of Gynecology and Obstetrics (FIGO). Now known as heavy menstrual bleeding, menorrhagia. Now known as abnormal uterine bleeding, menometrorrhagia.

Who does it affect?

The term "abnormal uterine bleeding" refers to bleeding in women who are not pregnant during their reproductive years. Contact your provider if you have undergone menopause and are bleeding. After menopause, bleeding is never typical. Blood can seem red, pink, brown, or even rust-like.

If you are bleeding while pregnant, you should also call your doctor. While some causes are benign, some necessitate medical care, particularly if the bleeding occurs toward the end of your pregnancy.

How common is abnormal uterine bleeding?

Not all women encountering unusual uterine bleeding notify their doctors of their problems. Therefore, 10% to 35% of women globally may experience abnormal uterine bleeding though they might be higher. Perimenopause and menarche are the two times when it occurs most frequently (the years leading up to menopause).

A lot of the time, abnormal uterine bleeding is caused by hormonal imbalances. People whose periods are just starting or nearly finished are more likely to experience them.

SYMPTOMS AND CAUSES

What are the symptoms of abnormal uterine bleeding?

The symptoms of unusual uterine bleeding can differ. A few indicators that your bleeding might be notable include:

Excessive menstrual bleeding (formerly called menorrhagia).

Bleeding at a strange time (between periods, after intercourse).

Unusually extended time frames (seven days or longer).

Erratic menstrual cycles.

What causes abnormal uterine bleeding?

Numerous medical disorders, including stress, can result in abnormal uterine bleeding.

imbalances in hormones

• Anovulation.
• Thyroid condition.
• Ovarian polycystic syndrome (PCOS).

Hormone imbalances brought on by being overweight or obese might also result in irregular uterine bleeding.

irregularities in your uterus's structure

• Polyps.
• Fibroids.
• Adenomyosis.

Cancer and its precursor

• ovarian cancer
• ovarian cancer.
• uterine cancer
• Breast cancer.
• Hyperplasia of the endometrium.

Infections

• Trichomoniasis.
• Cervicitis.
• Chlamydia.
• Gonorrhea.
• Endometritis.
• Vaginitis.

Additional medical issues

• illness of Von Willebrand.
• Liver illness.
• Kidney illness
• inflamed vulvar tissue (PID).
• Diseases of the platelets or leukemia.

Medications

• Both aspirin and blood thinners.
• replacement hormone treatment
• Tamoxifen (breast cancer medication) (breast cancer drug).
• Contraceptive implants (IUDs).
• Contraceptive tablets and injectables.

Trauma and retained foreign objects

IUD removal errors might result in irregular bleeding and infections. Another factor that can induce bleeding is uterine trauma brought on by accident.

DIAGNOSIS AND TESTS

How is abnormal uterine bleeding diagnosed?

When attempting to identify abnormal uterine bleeding, your healthcare practitioner will ask several questions. These inquiries might cover the following:

• What causes the bleeding to start?
• What more symptoms do you have?
• Are you expecting?

The next step is a physical examination by your healthcare professional, which includes the following:

• pelvic examination
• cervical examination
• A Pap test (Pap test)

What tests will be done to check this condition?

When determining the cause of irregular uterine bleeding, your healthcare professional may recommend several tests or treatments. These tests could consist of the following:

A pregnancy test. Miscarriages result in significant bleeding. Thirty-five days after a miscarriage, you can test positive for pregnancy. Additionally, typical in the early stages of pregnancy is little bleeding.

A blood test. Your doctor can perform a full blood count and examine your blood's ability to clot thyroid examination Problems with your thyroid function may be a clue that your ovarian function is also problematic, which may be the source of your bleeding.

I was checking hormone levels. Hormonal imbalances could bring on abnormal bleeding, or it could be a symptom of another ailment.

A hysteroscopic examination of the lining of your uterus (endometrium). This examination looks for polyps, fibroids, or indications of malignancy.

Ultrasonography of the womb. With the aid of imaging, your doctor can look for any growths in your reproductive organs that might be the source of your bleeding. 

A sonohysterogram, also known as saline-infusion sonography, is a sensitive imaging treatment that can assist your healthcare professional in locating abnormal uterine structures like polyps or fibroids.

Your healthcare provider can take tissue samples from the lining of your uterus and examine them for indications of cancer or pre-cancer cells.

MANAGEMENT AND TREATMENT

How is abnormal uterine bleeding treated?

Your course of action will depend on the nature of the bleeding. Medical and surgical solutions are available to control your bleeding or address the underlying cause.

Medications

The following medicines are used to treat irregular uterine bleeding:

• Contraceptive tablets.
• Progestin (may be delivered by a shot, implant, or device inserted in your uterus called an IUD) (can be given by a shot, implant, or device placed in your uterus called an IUD).
• One example is ibuprofen (Advil®, Motrin®), nonsteroidal anti-inflammatory medicine (NSAID).
• Gonadotropin-releasing hormone (GnRH) agonists might momentarily stop or lessen bleeding by delaying ovulation.
• Antibodies against gonadotropin-releasing hormone (GnRH) like elagolix® can control heavy menstrual bleeding by fibroids.

Surgery

Treatment options for irregular uterine bleeding range widely. Please inquire with your doctor how frequently they carry out a specific procedure. Visiting a doctor who conducts the operation frequently results in a quicker recovery with fewer complications.

Hysteroscopy. is a treatment when your doctor removes abnormal uterine formations like polyps and fibroids.

Stenting of the uterine artery. Reduces blood supply to fibroids, which shrinks them.

Myomectomy. Removes fibroids while maintaining your uterus's integrity and capacity to become pregnant and have children.

Ablation of the endometrium. It uses a laser, heat, electricity, microwave energy, or freezing to obliterate the uterine lining. This surgery is not recommended if you want to become pregnant and have children.

Hysterectomy. takes away your uterus. Treatment for cancer or malignant changes in your endometrium frequently involves a hysterectomy. Radiation or chemotherapy may be required for advanced cancer stages.

PREVENTION

How can I reduce my risk?

Many reasons for irregular uterine bleeding cannot be avoided. However, you can lower your risk of developing illnesses that can cause unusual bleeding. For instance, maintaining a healthy weight may contribute to the balance of your hormones. You can lower your chance of developing some cancers by avoiding diets heavy in animal fat. Your risk of contracting some STIs that can lead to abnormal uterine bleeding can be de