Abnormal Uterine Bleeding

It is normal for a woman's menstrual bleeding to last up to seven days. Abnormal bleeding can occur when the menstrual period is not regular, when bleeding lasts longer than normal, is heavier than normal, or when bleeding patterns change.

Causes
There are many causes of abnormal bleeding. Your doctor may begin looking for the cause of abnormal bleeding by checking for problems most common in your age group.

Diagnosis
To diagnose abnormal bleeding, your doctor will need to know your personal and family health history. You may be asked about:

Past or present illnesses
Use of medications
Use of birth control
Weight, eating, exercise habits and level of stress

You will have a physical exam. You also may have blood tests to check your blood count and hormone levels and a pregnancy test (to see if you are pregnant). One or more of the following tests also may be needed based on your symptoms:

Endometrial biopsy
Ultrasound
Sonohysterography
Hysteroscopy
Dilation and curettage (D&C)
Hysterosalpingography
Laparoscopy

Most of these tests can be done in your doctor's office. Others may be done at a hospital or other facility.

Treatment
Treatment for abnormal bleeding will depend on many factors, including the cause, your age, the severity of the bleeding, and whether you want to have children.

Hormones
Your doctor may prescribe birth control pills to help your periods to be more regular. They also may improve other symptoms. Progesterone can help prevent and treat endometrial hyperplasia.

Other Medications
Nonsteroidal antiinflammatory drugs, like ibuprofen, may help control heavy bleeding.

Surgery
Some women with abnormal uterine bleeding may need to have surgery to remove growths (such as polyps or fibroids) that are causing the bleeding.

Endometrial ablation also is used to treat abnormal uterine bleeding.

Hysterectomy — removal of the uterus — is another procedure that may be used to treat abnormal bleeding.

Hysterectomy is major surgery.

Finally ...
If you notice that your cycles have become irregular, see your doctor. Abnormal bleeding has a number of causes. There is no way of telling why your bleeding is abnormal until your doctor examines you. Once the cause is found, abnormal bleeding often can be treated with success.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.