Causes

Abnormal uterine bleeding is frequently a sign that something is wrong with your body. Among the causes are:

• Pregnancy
• Ectopic conception (a fertilized egg implanted outside the uterus)
• Miscarriage
• Birth control methods, such as IUDs and birth control pills
• Changing birth control methods
• Hormone replacement therapy during menopause
• Sexual encounters
• Hormone fluctuations during puberty and perimenopause
• Thyroid issues (hypothyroidism or hyperthyroidism)
• Adenomyosis (tissue that normally lines the uterus grows into the muscular wall of the uterus)
• Polycystic ovary syndrome (PCOS)
• Polyps or fibroids in the uterus
• Infections that affect the reproductive system or are transmitted sexually
• Gluten intolerance
• Kidney or liver disease
• Disorders of blood clotting or medications
• Infection or inflammation of the cervix or uterine lining
• Cancer of the cervix, vagina, ovaries, or uterus

Diagnosis

When working to recognize abnormal uterine bleeding, your healthcare provider will enquire you several questions. These inquiries may include:

• What causes the bleeding?
• What other signs are you having?
• Are you expecting a child?

Your healthcare provider will then perform a physical exam, which will include:

• Pelvic examination.
• Cervical examination.
• Pap test (Pap test).

When assessing abnormal uterine bleeding, your healthcare provider may order several tests or procedures. Among these tests are:

• A pregnancy test Heavy bleeding occurs during a miscarriage. A pregnancy test can be positive up to 35 days after a miscarriage. In the early stages of pregnancy, light bleeding is also common.
• Blood tests are performed. Your provider can examine your blood clotting and perform a complete blood count.
• Thyroid examination Problems with thyroid function may be an indication of a problem with ovary function, which could be causing your bleeding.
• Hormone levels are measured Hormone imbalances may be the cause of your abnormal bleeding, or they may be a symptom of another condition.
• A hysteroscopic examination of the lining of your uterus (endometrium). This test looks for fibroids, polyps, or cancerous cells.
• An ultrasound of the pelvis Your provider can use imaging to look for any growths in your reproductive organs that could be causing your bleeding. A sonohysterogram, also known as saline-infusion sonography, is a highly sensitive imaging procedure that can assist your provider in identifying abnormal uterine structures such as polyps or fibroids.
• Biopsy Your provider can take tissue samples from the lining of your uterus to look for signs of cancer or pre-cancer cells.

Risk Factors

The emergence of abnormal uterine bleeding can be attributed to a variety of risk factors. These consist of:

• Age: Women over the age of 45 and adolescents are at higher risk.
• Obesity: Women who are overweight or obese are at higher risk.
• Medication: Women who take cancer medications, anti-inflammatory drugs, or blood thinners are at greater risk.
• Birth control: Women who use an IUD or other form of birth control run a higher risk.

Treatment for Abnormal Uterine Bleeding

Your course of action will depend on what’s causing the abnormal uterine bleeding; if a chronic illness or blood condition is the source of your symptoms, treating those conditions can be helpful.

Whether you intend to have children can also affect your treatment. After some treatments, it might not be safe to become pregnant, while after others it might be impossible. The doctor might decide to wait and see if you’re close to menopause because your symptoms could go away on their own.

Your doctor will typically start treating you with medication. They consist of:

• Hormones: You may be able to have regular menstrual cycles and lighter periods with the help of birth control pills and other hormone therapies.
• Agonists of gonadotropin-releasing hormone (GnRHa): These prevent your body from producing particular hormones. They can temporarily reduce fibroids, but they are typically combined with other therapies.
• NSAIDS: Anti-inflammatories like ibuprofen and naproxen can help lessen bleeding if taken a few days before the start of your period.
• Tranexamic acid: This medication can control heavy uterine bleeding and aid in blood clotting.
• IUD: An IUD that releases the hormone progestin may be able to stop heavy bleeding in some women. Many women who use one never even get their period.

Surgery may occasionally be required to stop the bleeding:

• Ablation of the endometrium: This works to remove the lining of your uterus using heat, cold, electricity, or a laser. Your period may completely stop as a result. After having it done, you most likely won’t be able to get pregnant, but if you do, it could be dangerous. Until menopause, you must use birth control.
• Myomectomy or embolization of the uterine artery: The doctor may remove fibroids or close the blood vessels that supply them if you have them.
• Hysterectomy: This is the time your uterus is removed by the doctor. If your fibroids are very large or you have endometrial or uterine cancer, you might need a hysterectomy. In any other case, it’s the last resort after all other options have failed.

Prevention

There aren’t any definite precautions you can take to avoid abnormal uterine bleeding. However, there are ways to lessen the risk factors, and they include the following:

• If you suspect that your birth control method is what’s causing your abnormal uterine bleeding, change it.
• Consult your doctor about changing any medications you are taking if you think they may be the source of your bleeding.
• Maintain a healthy weight and body by exercising frequently and eating a diet rich in whole, fresh foods.