Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) refers to any irregular or unusual bleeding from the uterus, which can be caused by a variety of factors. It is a common symptom that affects many women at some point in their lives.

Types of Abnormal Uterine Bleeding

• Menorrhagia: Heavy or prolonged menstrual bleeding, lasting more than 7-10 days.
• Metrorrhagia: Irregular or frequent bleeding between periods.
• Polymenorrhea: Frequent menstrual cycles with intervals of less than 21 days.
• Oligomenorrhea: Infrequent menstrual cycles with intervals of more than 35 days.
• Amenorrhea: Absence of menstruation for more than 3 months in a woman who has previously had regular periods.

Causes of Abnormal Uterine Bleeding

The causes of AUB can be categorized into several groups, including:

• Hormonal Imbalance: Changes in estrogen and progesterone levels can disrupt the normal menstrual cycle.
• Uterine Abnormalities: Fibroids, polyps, or other growths in the uterus can cause irregular bleeding.
• Cancer: Uterine cancer, cervical cancer, or ovarian cancer can cause abnormal uterine bleeding.
• Infections: Pelvic inflammatory disease (PID) or other infections can cause inflammation and bleeding in the uterus.
• Medications: Certain medications, such as blood thinners or hormone replacement therapy, can affect menstrual bleeding.
• Other Medical Conditions: Thyroid disorders, liver disease, or kidney disease can also cause abnormal uterine bleeding.

Symptoms and Diagnosis

The symptoms of AUB may include:

• Heavy or prolonged menstrual bleeding
• Irregular or frequent bleeding between periods
• Pelvic pain or cramping
• Bloating or swelling in the abdomen

To diagnose AUB, a healthcare provider may perform:

• A physical exam and medical history
• Pelvic exam
• Ultrasound or other imaging tests to visualize the uterus and ovaries
• Endometrial biopsy to examine tissue from the uterine lining
• Hormone level tests to check for hormonal imbalances

Treatment Options

The treatment of AUB depends on the underlying cause and may include:

• Hormonal Therapies: Birth control pills or other hormone replacement therapies to regulate menstrual cycles.
• Surgical Interventions: Removal of fibroids, polyps, or other growths in the uterus.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) or other medications to reduce bleeding and pain.
• Lifestyle Changes: Maintaining a healthy weight, exercising regularly, and managing stress to help regulate menstrual cycles.

Complications and Prognosis

If left untreated, AUB can lead to complications such as:

• Anemia due to heavy blood loss
• Infertility or difficulty getting pregnant
• Increased risk of uterine cancer or other cancers

The prognosis for women with AUB depends on the underlying cause and effectiveness of treatment. With proper diagnosis and management, many women can experience significant improvement in their symptoms and quality of life.