Abnormal uterine bleeding, also known as Dysfunctional uterine bleeding is irregular bleeding from the uterus other than normal periods. Uterus, also referred to as the womb, is where a baby grows inside their mother.
Bleeding (spotting) between periods, after sex, heavy bleeding which lasts for more than 7 days in the menstrual cycle, and bleeding after menopause are the various modes of abnormal bleeding.
Causes of abnormal uterine bleeding include:
- Fibroid tumors
- Endometrial/uterine polyp or cancer
- Hormonal imbalance (estrogen and progesterone) that happens most often in women nearing menopause or after menopause
- Ectopic pregnancy
- Polycystic ovarian syndrome (PCOS)
- Cancer of the cervix or vagina
- Use of birth control measures such as oral pills or intrauterine device (IUD)
Abnormal uterine bleeding can occur at any age in a women’s life.
Your doctor will diagnose the condition by performing physical examination, including pelvic exam and taking a medical and family history. They may order a few tests to rule out other causes of abnormal bleeding. These tests include:
- Pregnancy test: To confirm whether you are pregnant.
- Blood count: To rule out blood disorders.
- Pelvic ultrasound: It is an advanced imaging test that uses high-frequency sound waves to create pictures of the female pelvic organs (uterus and ovaries).
- Endometrial biopsy: It is a procedure that involves sampling of the cells lining the uterus (endometrium) for any abnormalities.
- Hysteroscopy is a minor and fairly safe surgical procedure used for diagnosis and/or treatment of various conditions of the uterus. In this procedure, a thin magnifying instrument called hysteroscope is inserted into the uterus through the vagina to view the internal structures for diagnosing or treating the conditions. The camera in the hysteroscope displays the images on to the monitor thereby helping the surgeon to view the internal structures.
The treatment plan depends on a number of factors such as your age, cause of bleeding, and whether you are planning to become pregnant. The treatment options include:
- Birth control pills help to maintain regular periods.
- IUD that releases hormones: IUD is a birth control device that is inserted in the uterus. Abnormal bleeding may be controlled through the release of hormones.
- Dilatation and curettage (D & C) is a surgical procedure in which the cervix is expanded with a dilator and the tissue lining the uterus (endometrium) is scraped with a curette.
- Hysterectomy is the surgical removal of the entire uterus. This procedure will stop periods and is not suggested in women who desire to have children.
- Endometrial ablation: A procedure in which the tissue lining the uterus is destroyed by various ablation techniques such as laser beam, freezing, or heating.
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