Abnormal uterine bleeding

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Abnormal uterine bleeding
When female bleeding becomes abnormal
What is meant by abnormal uterine bleeding?
Uterine bleeding is considered abnormal in the following conditions:
Bleeding between periods
Bleeding after intercourse
Spotting at any time of the menstrual cycle

  • Bleeding more intense or longer than usual
    Bleeding after menopause
    Cycles longer than 35 days and shorter than 21 days are abnormal. Stopping periods for 3-6 months (amenorrhea) is also considered abnormal.
    What factors are considered when deciding on treatment?
    There are three types of treatment:
    1) Using medicine, such as hormones
    2) Use of surgery
    3) Patience and observation before resorting to other two ways
    Choosing the type of treatment depends on many factors, including: the cause of bleeding, the age of the patient and his desire to have children. However, most patients are treated with medication.
    What medications are used to help control abnormal bleeding?
    Hormonal drugs are often used to control abnormal uterine bleeding.
    The type of hormone that should be taken depends on the age of the patient and her desire to get pregnant. Birth control pills may make periods more regular. These hormones are administered in the form of injections, vaginal creams, or IUDs that release the hormones themselves.
    An IUD is a contraceptive device that is placed inside the uterus. (The hormones embedded in the IUD are released slowly and may control abnormal bleeding.)
    It is possible that the bleeding is caused by endometrial hyperplasia (in this case, the uterus becomes very thick). Medicines can also be used to prevent and treat this condition.
    What type of surgery is used to treat abnormal bleeding?
    Some women may need surgery to remove lumps that are causing bleeding (such as fibroids). Some fibroids can be removed hysteroscopy. Sometimes other techniques are necessary (such as Endometria ablation, which is used with the aim of stopping or permanently reducing bleeding, but a biopsy must have been done before that)
    A hysterectomy may be performed when other forms of treatment are no longer responsive or basically ineffective. A hysterectomy is a major surgery in which the uterus is removed from the body. After this procedure, women will no longer have periods.

What is a normal menstrual cycle?
Each menstrual cycle starts on the first day of bleeding of a period and ends on the first day of the next cycle. In most women, this cycle lasts about 28 days (that is, the distance from the first day of the period to the first day of the next period = 28 days). Normal cycles are 21 to 35 days. At what age is abnormal bleeding more common?
Abnormal bleeding can occur at any age. However, at certain times of women’s lives, this condition is more common. In the first years of the onset of periods (about 9-16 years old), periods may not be very regular. Around the age of 35, periods become shorter. As menopause approaches, periods often become shorter. Also, sometimes the period does not occur or the bleeding becomes lighter or heavier.

What are the causes of abnormal bleeding? An increase or deficiency of hormones that regulate the menstrual cycle can cause abnormal or heavy bleeding. Many factors can disrupt the balance of hormones, such as:

  • Some medicines
    -Pregnancy
    -Abortion
    Ectopic pregnancy
    -Problems related to birth control methods such as IUDs or pills
  • Infection of the uterus or its opening
  • Fibroids
  • Blood clotting problems
  • Polyps
  • Certain types of cancer such as uterine, cervical or vaginal cancer
    -Chronic diseases (such as thyroid problems or diabetes) first, the doctor examines the common problems of the person’s age group. Some of these problems are not serious and can be treated easily. Others may be more serious, but they should all be investigated.
    How is abnormal bleeding diagnosed?
    In order to find the cause, the doctor will ask about personal and family medical history as well as menstrual cycles. Therefore, before going to the doctor, it is better to take notes about your periods (start date, duration of bleeding, intensity of bleeding, presence of spotting).
    Your doctor may examine you and ask you for a blood test. These tests are done to check the blood cell count and determine the amount of hormones in order to rule out some blood diseases. The doctor may also check you for pregnancy.
    What tests may be needed to diagnose abnormal bleeding?
    Depending on the symptoms, other tests may be done. Some of these tests can be done in the doctor’s office, but some must be done in special centers:
    Ultrasound: Imaging is performed using sound waves from the organs inside the pelvis.
    Endometrial biopsy: with a special device, a piece of the uterine wall (endometrium) is removed and examined under a microscope.
    Sonohysterography: With the help of a thin tube, liquid is poured into the uterus, simultaneously and with the help of ultrasound, the uterus is imaged.
    Hysterosalpingography: A dye is injected into the uterus and fallopian tubes and then X-rays are taken.
    Dilation and curettage (D&C): The cervix is ​​dilated and then the tissue of the uterine wall is gently scraped or suctioned, then examined with a microscope.
    Laparoscopy: A narrow device similar to a telescope (through an incision just below or on the navel) is inserted into the body and the inside of the abdomen is observed with its help.

Producer: Khadija Youneszadeh
Source: Williams
Compilation date: Autumn 1400
Revision date: 3 years later

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