Abnormal or prolonged uterine bleeding, also known as abnormal menstrual bleeding, is when bleeding does not follow a normal pattern as it would during the menstrual cycle. Typically, a woman passes around 40ml of blood during her menstrual period, which is expected to last between four to seven days. However, some women find that their bleeding is excessive or goes on for longer than expected.
Symptoms And Causes Of Abnormal Uterine Bleeding
Symptoms of abnormal uterine bleeding which may require medical attention include;
- Any bleeding which goes on for more than eight days
- A heavy blood loss during the menstrual period, especially if you are soaking through one or more sanitary pad or tampon hourly
- Having to change your sanitary pad during the night
- Having to change or even restrict your daily activities as a result of the heavy bleeding
- Irregular bleeding or spotting between your period
- Cramping and feelings of pain in the lower abdomen
- Fatigue
- Any form of vaginal bleeding following menopause.
Abnormal uterine bleeding can be a result of several different issues; unfortunately, sometimes it is not always possible to determine the exact cause. Some of the known causes of abnormal bleeding can include;
- A spontaneous miscarriage or ectopic pregnancy
- Hormonal disorders, such as hypothyroidism, polycystic ovarian syndrome (PCOS) or hyperprolactinemia
- Hormone-based contraceptives
- Hormone replacement therapy
- The presence of fibroids and polyps
- Endometriosis, when the cells that line the uterus travel to and attach, then grow elsewhere within the body. This is most commonly on the outside of the uterus or on the ovarian surface
- Ovulatory dysfunction, where the ovary does not release an egg each month. This commonly occurs either during early puberty or at menopause
- Infections such as sexually transmitted infections
- Medications such as anticoagulants, phenothiazine’s, and tricyclic antidepressants
- Bleeding disorders such as leukemia and Von Willebrand disease.
- IUDs which act as a foreign body within the uterus and can prompt heavier periods
- Uterine cancers. These are most common after menopause.
Treatments For Abnormal Uterine Bleeding
Treatment options for abnormal uterine bleeding are largely dependent on the cause of the bleeding. Often treatments can include;
- Medication which comprises prostaglandin inhibitors, hormone replacement therapy or antibiotics
- Dilation and gentle scraping of the cervix and lining of the uterus
- Changes in contraception as sometimes the IUD and hormones can trigger excessive bleeding
- Surgery to remove tumour’s, polyps or fibroids
- Surgery to treat an ectopic pregnancy
- Treatment of underlying medical disorders such as hypothyroidism or bleeding disorders
- Hysterectomy. This is a removal of the entire uterus and is considered a drastic last resort but should be considered if there is a serious disease such as cancer present.
If you are suffering from excessive, prolonged, or spontaneous uterine bleeding, then you should seek medical advice to rule out any underlying disorders. You can speak to your doctor, gynaecologist, or a family planning clinic for more information and advice that will remain completely confidential.
