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Abnormal uterine bleeding: Treatment, symptoms, advice and help

About abnormal uterine bleeding

Abnormal uterine bleeding is one of the most common gynaecological problems and essentially means abnormal bleeding from the vagina.

Abnormal uterine bleeding: Incidence, age and sex

Abnormal uterine bleeding can occur at any age but it seems to be more common in adolescents and peri menopausal women.

Causes and prevention of abnormal uterine bleeding

There are several causes of abnormal uterine bleeding. It can be due to certain disorders of the genital tract, hormonal imbalances or other systemic causes.

Localised gynaecological causes of abnormal uterine bleeding include abortion, benign growths in uterus called fibroids and polyps, malignancy of the uterus, the cervix or the vagina, or may be related to insertion of intra uterine devices. Ectopic pregnancy in which the product of conception is placed outside the uterus may also lead to abnormal bleeding.

Other non-gynaecological causes include thyroid problems, pituitary tumours, bleeding disorders, anaemia, mental stress and certain medications like birth control pills.

Signs and symptoms of abnormal uterine bleeding: Diagnosis

Any kind of vaginal bleeding except menstrual bleeding is abnormal. It includes both increased amount as well as reduced amount of vaginal bleeding. A menstrual cycle exceeding 35 days or less than 21 days constitute abnormal uterine bleeding. Vaginal bleeding between periods or intermenstrual bleeding is abnormal. Moreover, mid cycle spotting, post menopausal bleeding or vaginal bleeding after sexual intercourse are also signs of abnormal bleeding. Absence of periods in a woman for more than 6 months without any apparent cause is a feature of abnormal uterine bleeding as well.

Abnormal uterine bleeding: Complications

There are usually no complications of abnormal uterine bleeding unless the bleeding is substantial. Long-term excessive bleeding may cause reduced haemoglobin or anaemia. Sudden excessive blood loss might result in shock which is a medical emergency. Other complications might arise due to the underlying cause of abnormal bleeding.

Abnormal uterine bleeding: Treatment

The treatment of abnormal uterine bleeding depends not only on its underlying cause but also the woman’s age and her family status regarding children. The treatment modalities include hormonal medication and surgery.

Hormonal medication may help in maintaining hormonal balance thereby preventing abnormal bleeding from the uterus. Such medicine may be given in tablet form, injections, vaginal creams for topical applications or via intra uterine devices. Antibiotics are recommended if the bleeding is accompanied by fever and infection.

Surgical treatment modality includes hysteroscopy, hysterectomy and endometrial ablation. Hysteroscopy is indicated in the treatment of uterine fibroids and polyps. Hysterectomy involves removal of uterus and its appendages. This kind of surgery is not advisable for women of reproductive age since the patient cannot opt for pregnancy after this surgery.

Endometrial ablation destroys the uterine lining, thereby controlling excess bleeding. Sometimes abnormal uterine bleeding is self limiting and returns to normal within a few months. Finally, the underlying cause of bleeding needs to be correctly diagnosed and managed effectively.