Abnormal uterine bleeding (AUB) is a condition that most women will experience at least once, and probably several times, during their reproductive years.Heavier flow than usual (a.k.a. menorrhagia) is one kind of AUB, and the most likely time for this to happen is during the early years of menstruation, and again in the last few years of it. While there are several different instances of AUB which are considered ‘abnormal’ bleeding, these do not apply during pregnancy, which of course has a set of circumstances all its own.
What constitutes abnormal uterine bleeding?
As mentioned above, the most common type of AUB is a heavier flow than usual during your menstrual cycle. This may be noticeable because it necessitates changing pads more than once every hour or so, or you may find your period lasting longer than seven days. Other signs of abnormal bleeding are spotting between periods, bleeding immediately after having sex, and bleeding after menopause. The AUB condition is also used to describe the absence of menstruation, which in itself is abnormal.
Causes of AUB
There are various causes of AUB, which is not surprising since there are several kinds of AUB, and all of them are cause for some concern, and should be checked out with your physician. Some occurrences of menorrhagia are due to hormonal imbalance, while others have more serious causes. Heavy bleeding is sometimes caused by fibroid tumors, which commonly occur in women between 30 and 45, and develop in the uterus as fibrous tissue. While almost always benign, their presence can disrupt normal menstruation.
Benign cervical or endometrial polyps can be another cause of AUB, as can cervical or endometrial cancers. Pelvic inflammatory disease (PID) is an infection which can occur in any of the pelvic organs, including the uterus, cervix, or fallopian tubes, and the infection can then trigger AUB. Another possible cause is lupus, although this can be one of the more difficult diseases to accurately diagnose.
AUB diagnosis
Diagnosing AUB will often involve several types of examination by a physician, usually starting with a pelvic exam and a PAP test. A complete blood count test (CBC), a blood clotting profile, and tests to check on hormone levels may be worked up to provide further information. A pregnancy test may be administered, and thyroid function tests may also be considered. In some cases, a physician might recommend additional measures such as an infection culture, a biopsy, a sonohysterography, ultrasound or even a MRI to scan for potential issues in the pelvis or uterus.
Apart from all these, your physician will probably also try to gain some insights from your medical history and present state of well-being, looking for anything which may be contributing to abnormal uterine bleeding. For instance, you might be asked about your usage of medication, any recent illnesses, usage of birth control, and about any current causes of stress in your life.
Treatment of AUB
If it is readily apparent that abnormal bleeding is not associated with any underlying disease, an oral contraceptive, intrauterine devices containing progestins may be used to help regulate bleeding. Frequent AUB is sometimes a sign of anemia, in which case treatment would call for an iron supplement in the diet. Ibuprofen and naproxen are often used because of their anti-inflammatory properties, and they also work to reduce the pain or discomfort associated with menstrual cramping.
In some cases, surgery is recommended, especially in women over 40 who may not wish to become pregnant again. In this kind of procedure, known as an ablation, tissue is removed from the lining of the uterus and uterine lining gets destroyed. A hysterectomy may also be performed for definitive treatment. Hysterectomy can be done laparoscopic, vaginal or abdominal. Laparoscopic hysterectomy is a minimal invasive surgery that will allow for a faster recovery.