Abnormal uterine bleeding is irregular bleeding from the uterus. It may be bleeding that is heavier, lighter, lasts longer than your usual period, or that doesn't occur at your regular time.
Sometimes it is caused by changes in hormone levels. It can also be caused by growths in the uterus, such as fibroids or polyps. Sometimes a cause cannot be found.
Symptoms
Abnormal uterine bleeding is unpredictable. The bleeding may be very heavy or light, and can occur often or randomly.
Symptoms include:
Bleeding or spotting between periods
Bleeding or spotting after sex
Heavy bleeding during your period
Bleeding that soaks through one or more tampons or pads every hour
Bleeding that lasts more than 7 days
Menstrual cycles that are shorter than 21 days or are longer than 35 days
Not having a period for 3 to 6 months
Bleeding after menopause
Other symptoms caused by changes in hormone levels may include:
Excessive growth of body hair in a male pattern (hirsutism)
Hot flashes
Mood swings
Tenderness and dryness of the vagina
A woman may feel tired or fatigued if she loses too much blood over time. This is a symptom of anemia.
Causes
In many women, abnormal uterine bleeding is caused by hormone imbalance. It can also occur due to following causes:
Hormonal birth control, such as birth control pills or intrauterine devices (IUD)
Lack of ovulation
Uterine fibroids or polyps
Polycystic ovary syndrome
Bleeding disorders or problems with blood clotting
Severe weight loss
Excessive weight gain or loss (more than 10 pounds or 4.5 kilograms)
Infection of the uterus or cervix
Cancers of ovaries, uterus, cervix, or vagina
Diagnosis
Your provider will rule out other possible causes of irregular bleeding. You will likely have a pelvic exam and Pap/HPV test. Other tests that may be done include:
Complete blood count (CBC)
Fasting blood glucose
Hormone tests
Pregnancy test
Thyroid function tests
The following may also be recommended:
Culture to look for infection
Biopsy to check for precancer, cancer, or to help decide on hormone treatment
Hysteroscopy, performed in your provider's office to look into the uterus through the vagina
Ultrasound to look for problems in the uterus or pelvis
Treatment
Treatment may include one or more of the following:
Low-dose birth control pills
Hormone therapy
High-dose estrogen therapy for women with very heavy bleeding
Intrauterine device (IUD) that releases the hormone progestin
Nonsteroidal anti-inflammatory drugs (NSAIDs) taken just before the period starts
Surgery, if the cause of the bleeding is a polyp or fibroid
