Facing issues with your period? Understanding abnormal uterine bleeding could be the answer

Abnormal uterine bleeding (AUB) is described as a condition where women experience unusual bleeding which is not part of the regular menstrual cycle. This can occur in the form of bleeding or spotting between periods, bleeding after intercourse, heavy menstrual bleeding, irregular periods, or bleeding after menopause.

To understand more about this condition, its symptoms, causes and treatment, we spoke to Dr Vinuta, co-founder and deputy medical director at Athreya Hospital, who said, “Normal menstrual periods typically occur every 25-35 days and last for 3-5 days. The flow is usually moderate, with an average blood loss of around 30-80 ml.” Abnormal uterine bleeding, she explained, refers to any bleeding outside of this pattern. This can include:

• Bleeding between periods
• Prolonged bleeding that lasts more than 7 days
• Extremely heavy periods with large clots, requiring frequent pad changes (more than 5-6 per day)

Underlying causes of abnormal uterine bleeding

In case of abnormal uterine bleeding, Dr Vinuta suggests that there can be several underlying causes that can contribute to this. Some common ones include:

Hormonal imbalance

This can be caused by conditions like polycystic ovary syndrome (PCOS), thyroid disorders, or anovulatory cycles (when ovulation doesn’t occur).

Structural issues

These may include uterine fibroids (non-cancerous tumours), polyps (growths on the uterine lining), or adenomyosis (uterine tissue growing in the muscle wall).

Bleeding disorders

In some cases, certain underlying bleeding disorders can contribute to abnormal menstrual bleeding.

Cancer

While less common, abnormal uterine bleeding can sometimes be a symptom of uterine cancer, and one should get it tested as soon as possible.

Get yourself checked by a medical professional if you suspect that you may have symptoms of abnormal uterine bleeding. (Source: Freepik)

Diagnostic tests or examinations for abnormal uterine bleeding

Several tests can help diagnose abnormal uterine bleeding, Dr Vinuta shares, however the accuracy depends on the specific situation, but these tests often provide a clear picture to your doctor:

• Clinical examination: This includes a discussion of your medical history and a physical examination, focusing on the pelvic area.
• Pelvic ultrasound: This painless imaging test uses sound waves to create images of the uterus and ovaries.
• Blood tests: These can assess hormone levels and screen for other underlying conditions.
• Hysteroscopy: A thin, lighted scope is inserted into the uterus to examine the uterine lining directly.
• Biopsy: A small tissue sample may be taken from the cervix or endometrial lining for further analysis.

Available treatment options for managing abnormal uterine bleeding

The treatment approach for abnormal uterine bleeding depends on your age, the underlying cause, and the severity of your symptoms. Common treatment options according to Dr Vinuta include:

Medical management

• NSAIDs (Non-steroidal Anti-inflammatory Drugs) for pain relief.
• Birth control pills or hormonal therapy to regulate menstrual cycles.
• Hormone-releasing intrauterine devices (IUDs) for localised hormonal treatment.
• GnRH agonists (Gonadotropin-releasing hormone agonists) to temporarily suppress ovulation and bleeding.

Surgical management

• Hysteroscopic polyp removal for removing polyps within the uterus.
• Myomectomy for surgically removing fibroids.
• Endometrial ablation to destroy the lining of the uterus (may not be suitable for everyone).
• Uterine artery embolisation to block blood flow to fibroids, shrinking them.
• Hysterectomy (surgical removal of the uterus) as a last resort.

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