ABOUT ABNORMAL UTERINE BLEEDING
We all want to live our best lives. But for many, abnormal uterine bleeding (AUB) gets in the way.
It may be more common than you think — 100 million women around the world are impacted by AUB,1 which includes situations such as:2
- Bleeding or spotting between periods
- Heavy bleeding during your period
- Menstrual cycles that are longer than 38 days or shorter than 24 days
- Bleeding after menopause
The good news is: AUB can be treated.
WHAT IS ABNORMAL UTERINE BLEEDING?
Abnormal uterine bleeding can include prolonged, irregular, or even postmenopausal bleeding. If you’re one of the 100 million women who suffers from AUB,1 polyps or fibroids might be to blame.
WHAT ARE POLYPS?
Endometrial polyps grow from the lining of the uterus, known as the endometrium. These polyps cause irregular spotting and pre- or postmenstrual bleeding.
Cancerous polyps aren’t common, but the risk rises with increasing age and postmenopausal bleeding. That’s why doctors suggest removing these symptomatic polyps for testing.3
WHAT ARE FIBROIDS?
Uterine fibroids aren’t typically associated with an increased risk of uterine cancer — and they rarely develop into cancer. Still, they can cause back and pelvic pain, as well as heavy, prolonged, and/or frequent bleeding.4 Fibroids are a common health issue that affect:5
- 20% of childbearing-age women
- 70% to 80% of women 50 and younger
- 1 in 2 women in the United States
Submucosal fibroids grow and bulge toward the inside of the uterus. They are usually removed because they have been associated with these increased negative effects on fertility, including:6
- 64% reduction in pregnancy rates
- 69% reduction in live birth rates
- 67% increase in miscarriage rates
WHAT ARE RETAINED PRODUCTS OF CONCEPTION?
The term retained products of conception (RPOC) refers to intrauterine tissue that develops after conception and persists after a miscarriage, and vaginal or cesarean delivery. RPOC is one of the most common causes of postpartum bleeding and can also cause pain and/or fever.7
Women routinely have some uterine bleeding after a miscarriage, so it can be difficult to distinguish normal from abnormal bleeding. A reasonable approach is to assume that bleeding is probably abnormal if it is heavy (i.e., passage of large clots or flow that is significantly greater than a regular period, or not diminishing over time) or prolonged (i.e., lasting longer than three weeks).8
To learn more about retained products of conception, hear from a patient who was diagnosed with RPOC after multiple miscarriages — and find out how she was treated.
TREATMENT OPTIONS FOR ABNORMAL UTERINE BLEEDING
Treatments for AUB range from hormone therapy to complete removal of the uterus (hysterectomy). Between those extremes is a less invasive option called a hysteroscopy. This may be an option for you if your AUB is caused by polyps, fibroids, or retained products of conception.
1
Based on internal analysis of 2017 market model data. April 2018.
2
Abnormal Uterine Bleeding FAQ. The American College of Obstetricians and Gynecologists. FAQ095, March 2017.
3
American Association of Gynecologic Laparoscopists (AAGL). AAGL practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol. 2012:19(1)3-10.
4
Uterine fibroids. Office of Women's Health Website. https://www.womenshealth.gov/a-z-topics/uterine-fibroids. Updated Feb. 6, 2017. Accessed July 25, 2017.
5
Hickman D, Selby JV. Treatment options for uterine fibroids. Patient-Centered Outcomes Research Institute. https://www.pcori.org/meetings-events/past-events/treatment-options-uterine-fibroids. March 2013.
6
Kovacs P. Effects of fibroids on women’s fertility. Medscape website. http://www.medscape.com/viewarticle/701937. Published April 29, 2009. Accessed on Jan. 31, 2017.
7
Guarino A, Di Benedetto L, Assorgi C, Rocca A, Caserta D. “Conservative and timely treatment in retained products of conception: a case report of placenta accreta ritention.” Int J Clin Exp Pathol. 2015 Oct 1;8(10):13625-9.
8
Retained Products of Conception. Up to Date. https://www.uptodate.com/contents/retained-products-of-conception. Updated June 26, 2018. Accessed March 31, 2019.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.