OB/GYN > About Us > Gynecologic Care > Abnormal Uterine Bleeding

Abnormal Uterine Bleeding

Abnormal uterine bleeding is:

  • Bleeding between periods
  • Bleeding after sex
  • Spotting anytime in the menstrual cycle
  • Bleeding heavier or for more days than normal
  • Bleeding after menopause

Menstrual cycles that are longer than 35 days or shorter than 21 days are abnormal. The lack of periods for 3–6 months (amenorrhea) also is abnormal.

Causes

  • group of four womenPregnancy
  • Miscarriage
  • Ectopic pregnancy
  • Adenomyosis
  • Use of some birth control methods, such as an intrauterine device (IUD) or birth control pills
  • Infection of the uterus or cervix
  • Fibroids
  • Problems with blood clotting
  • Polyps
  • Endometrial hyperplasia
  • Certain types of cancer, such as cancer of the uterus, cervix or vagina
  • Polycystic ovary syndrome

Diagnosis

We will ask about your personal and family health history as well as your menstrual cycle. It may be helpful to track your menstrual cycle before your visit. Note the dates, length and type (light, medium, heavy or spotting) of your bleeding on a calendar.

You will have a physical exam. You also may have blood tests. These tests check your blood count and hormone levels and rule out some diseases of the blood. You also may have a test to see if you are pregnant.

Based on your symptoms, other tests may be needed. These include:

  • Sonohysterography—Fluid is placed in the uterus through a thin tube, while ultrasound images are made of the uterus.
  • Ultrasound—Sound waves are used to make a picture of the pelvic organs.
  • Magnetic resonance imaging—In this imaging test, powerful magnets are used to create images of internal organs.
  • Hysteroscopy—A thin device is inserted through the vagina and the opening of the cervix to view the inside of the uterus.
  • Endometrial biopsy—Using a small or thin catheter, tissue is taken from the lining of the uterus (endometrium) and examined under a microscope.

Treatment

The type of treatment depends on many factors, including the cause of the bleeding, your age and whether you want to have children. Most women can be treated with medications. Others may need surgery.

Hormonal medications often are used to control abnormal uterine bleeding. These medications may come in the form of pills, an injection, a vaginal cream or an IUD. Other medications include nonsteroidal anti-inflammatory drugs (such as ibuprofen), tranexamic acid and antibiotics.

Some women may need to have surgery to remove growths (such as polyps or fibroids) that cause bleeding. Some fibroids can be removed with hysteroscopy. Endometrial ablation may also be used to control bleeding. When other forms of treatment have failed, a hysterectomy may be done.

Source: American College of Obstetricians and Gynecologists.