If you have abnormal bleeding, you may either be used to it by now or you may feel alarmed. Abnormal bleeding is defined as any bleeding that occurs outside of a normal menstrual period, which should occur every 21 to 35 days and lasts for five days on average.
If you’re experiencing vaginal bleeding that occurs outside this window of time, it might indicate that something is wrong. Dr. Alan Patterson explains more about the potential causes of abnormal bleeding and how it can be treated.
How common is abnormal bleeding?
Abnormal uterine bleeding affects anywhere between 10-35% of women worldwide, although experts believe that the true number could be higher because many women don’t report their symptoms.
Abnormal bleeding is most common in the early years of menstruation (or the years after menarche, the first period) and during pre-menopause, the years leading up to your last period.
Hormone imbalances are usually to blame for abnormal bleeding, which are common at both the beginning and end of your menstruating years. However, they can also occur at other times as well.
How to diagnose abnormal bleeding
When you make an appointment about abnormal bleeding, we will do an overall physical exam, possible blood work, and most likely get you scheduled for a pelvic ultrasound. We may also do a hysteroscopy, a procedure where we look inside the uterus and take a sample of your endometrial lining. All of this is usually done in the office.
The causes of abnormal bleeding may include:
Stopping or changing birth control methods
If you have been taking a birth control pill for contraception, for example, it can alter your normal hormone production. Eventually, as your body adjusts to the contraception or lack thereof, your hormones should regulate themselves again.
Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome, or PCOS, is a very common hormone disorder, affecting 1 in 10 women. One of the hallmark symptoms of this hormone disorder is irregular menstruation. Other symptoms may include excess, irregular hair growth (hirsutism), acne, thinning hair on your head, and weight gain, especially around your abdomen.
Structural abnormalities of the uterus
Polyps and fibroids are abnormal growths on the inside of your uterus. They can also cause abnormal bleeding. Adenomyosis is another similar cause of abnormal uterine bleeding.
Many infections, including sexually transmitted infections, can also cause abnormal uterine bleeding. Some of these infections include the following:
Identifying these infections often means that you can get treatment for them, which can make the infections go away.
Although it’s not a common cause of abnormal bleeding, certain types of cancer can cause abnormal bleeding as well. These types of cancer include:
- Cervical cancer
- Endometrial cancer
- Uterine cancer
- Ovarian cancer
Other precancerous conditions like endometrial hyperplasia can also cause abnormal bleeding.
How to treat abnormal uterine bleeding
How we treat abnormal uterine bleeding depends on the cause of it. You may be prescribed medications such as birth control pills, progestin, non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil® (ibuprofen), or gonadotropin-releasing agonists or antagonists. Some patients may also be a candidate for a procedure called an endometrial ablation. This is a procedure where a coil is inserted in the uterus for 90 seconds which will get rid of the endometrial tissue which will, in effect, stop you from having periods or if you do have periods, they will be much lighter. Once again, 90% of the time this procedure can be done in the office.
If you have abnormal uterine bleeding, make an appointment to have it evaluated today. Contact Dr. Alan Patterson or request an appointment online.