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Abnormal Uterine Bleeding

The Women Like Me website aims to help you make sense of various gynecological conditions and symptoms, which may have a negative impact on your life.

Overview

Abnormal uterine bleeding (AUB) affects women of all ages and is the commonest reason woman to seek gynecological advice.1 From a healthcare point of view, it is also associated with high direct and indirect costs. Symptoms of AUB frequently co-exist with fibroids.1 The relationship between them, however, is not totally understood. In many women, fibroids may be an incidental innocent bystander in the underlying causes of a menstrual bleeding complaint.2

In some circumstances, AUB may even mask a (pre)cancerous uterine condition and therefore always justifies a detailed evaluation.2

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What is Abnormal Uterine Bleeding?

The following definitions describe menstrual patterns associated with AUB:

  • Oligomenorrhea: Cycle length greater than 35 days3
  • Polymenorrhea: Cycle length less than 21 days4
  • Menorrhagia: Heavier and increased menstrual bleeding5
  • Metrorrhagia: Irregular episodes of bleeding occurring outside of menses6
  • Menometrorrhagia: Longer duration of flow occurring at unpredictable intervals7
  • Postmenopausal bleeding: Bleeding that occurs more than 12 months after the last menstrual cycle8
  • DUB (Dysfunctional Uterine Bleeding): Erratic or irregular bleeding not associated with intrauterine pathology9
If you are experiencing any of these symptoms, don’t let them takeover your quality of life. Put your mind at rest and make time to consult your doctor or healthcare specialist.

What Happens Next?

You may be asked to undergo some tests to find out the definitive cause of these symptoms, which may be related to various gynecological conditions.

These tests include:

  • An endocrine blood profile (To measure the levels of various hormones and to learn if the endocrine glands are working correctly.
  • An intrauterine endoscopy called hysteroscopy (the doctor looks at the inside of the womb using a hysteroscope; a narrow tube with a telescope at the end)
  • An ultrasound (3D or gel-infused) or MRI scan of the uterus and ovaries
  • Dilation and curettage (D&C) is a procedure in which the cervix is dilated and a special instrument is used to to remove tissue from inside the uterus.

This type of procedure should be performed only under visualization. Since it is many times still performed blindly, it is recommended to perform it using an endoscope as the accuracy of the procedure is much higher and a false diagnosis can be avoided.10,11

Check out the different pathologies

Uterine Fibroids
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Uterine Polyps
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Uterine Cancer
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Cervical Cancer
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Don't neglect your own well being

If you're experiencing any of these symptoms make time to consult your doctor or healthcare professional.

Chronic Pelvic Pain
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Menopausal Symptoms
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Infertility

Learn More
Incontinence

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References:

1. Clark TJ, Middleton LJ, Cooper NAM, et al. A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding. Health Technology Assessment, No. 19.61. NIHR Journals Library; 2015 Jul.

2. L Whitaker et. Al. Abnormal uterine bleeding, Best Practice & Research Clinical Obstetrics & Gynaecology Volume 34, July 2016, Pages 54-65

3. Oligomenorrhea: Definition, Signs, and Treatments. (2021, June 30). WebMD. https://www.webmd.com/women/oligomenorrhea-definition-signs-and-treatments

4. Young, B. (2018, February 28). Polymenorrhea. Healthline. https://www.healthline.com/health/polymenorrhea

5. Oehler, M. K., & Rees, M. C. P. (2003). Menorrhagia: an update. Acta Obstetricia et Gynecologica Scandinavica, 82(5), 405–422. https://doi.org/10.1034/j.1600-0412.2003.00097

6. Ellis, M. E. (2019, September 23). Vaginal Bleeding Between Periods. Healthline. https://www.healthline.com/health/vaginal-bleeding-between-periods

7. Christiano, D. (2019, March 8). Everything You Should Know About Menometrorrhagia. Healthline. https://www.healthline.com/health/womens-health/menometrorrhagia

8. NHS website. (2021, November 18). Postmenopausal bleeding. Nhs.Uk. https://www.nhs.uk/conditions/post-menopausal-bleeding/

9. Pitkin J. Dysfunctional uterine bleeding. BMJ. 2007 May 26;334(7603):1110-1. doi: 10.1136/bmj.39203.399502.BE. PMID: 17525454; PMCID: PMC1877895.

10. Epstein E, Ramirez A, Skoog L, Valentin L. Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstet Gynecol Scand. 2001;80(12):1131–1136. ​

11. Bettocchi S, Ceci O, Vicino M, Marello F, Impedovo L, Selvaggi L. Diagnostic inadequency of dilation and curettage. Fertil Steril. 2001;75(4):803–805. ​