ABNORMAL (DYSFUNCTIONAL) UTERINE BLEEDING (AUB)

Condition

About once every 28 days, women of childbearing age who are not pregnant usually have a menstrual period, a discharge of blood and tissue from the uterus. There are several types of abnormal, or dysfunctional, uterine bleeding:

amenorrhea, when you have no periods at all
menorrhagia, when you bleed more heavily or for longer than normal
metrorrhagia , when you bleed or spot between periods
post-coital bleeding, when you bleed after having sexual intercourse
oligomenorrhea, when your periods are two or three months apart
polymenorrhea, when you have fewer than 21 days between periods

Causes

pregnancy (even with a normal pregnancy there may be bleeding in the first trimester)
ectopic (tubal) pregnancy or miscarriage
an intrauterine device (IUD)
birth control pills or hormone therapy
fibroid (benign) tumors or polyps in the uterus
cysts of the ovary
polycystic ovary syndrome, a condition in which you do not ovulate and tiny cysts form on the ovaries
endometriosis, a condition in which the tissue that normally lines the uterus grows in abnormal locations, such as on the ovaries or in the abdominal cavity
adenomyosis, which is endometriosis within the muscle layer of the uterus
infection of the uterus or cervix
adhesions (scar tissue) in the uterus
cancer of the female organs (vagina, cervix, uterus and ovaries)
medical illnesses, such as diabetes, thyroid, adrenal and liver disease
problems with the hypothalamus or pituitary gland, which control the function of the ovaries
radiation and/or chemotherapy

Treatment for AUB depends on the cause of the problem. To arrive at a diagnosis, your doctor may examine you and order blood tests, biopsies, imaging procedures (such as ultrasound or CT scan) or perform procedures that permit visual examination inside the body. Depending on the diagnosis, treatment may involve a wide range of possibilities including taking medication or having surgery.

WHEN TO CALL YOUR DOCTOR FOR ABNORMAL UTERINE BLEEDING

Call 911 Now (you may need an ambulance) If

You have AUB and pass out or faint.
Your AUB is so heavy you are soaking through sanitary pads or tampons every 10 to 15 minutes.
You are having a lot of abdominal pain with AUB.

Call Your Doctor Right Away (night or day) If

You have AUB and are feeling dizzy. You may be anemic.
You are pregnant and have AUB.

Call Your Doctor During Regular Office Hours If

You need an appointment because you have AUB.
You have AUB and want your IUD removed.
You have AUB and want to change or stop taking your birth control pills.
You have AUB and want to change or stop taking hormone therapy.
You have bleeding after sex.
You missed a period and think you may be pregnant.
You have not had a period for two or more months.
You are 16 years old and have not yet had a period.
You are more than 55 years old and are still having periods.

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HOME CARE ADVICE FOR ABNORMAL UTERINE BLEEDING

Take as directed any medications your doctor prescribes.

If you bleed heavily or more often than normal, take multivitamins with iron to help prevent anemia. Avoid taking aspirin or medicines that contain aspirin because it may increase bleeding.
If you are bleeding heavily, lie down with your feet elevated above the level of your heart. Getting off your feet and elevating them slows down the bleeding.
If you have heavy bleeding, apply a cold compress to your lower abdomen for 15 minutes, three or four times a day. The cold will constrict blood vessels and slows down the bleeding.
To help your doctor with diagnosis and treatment decisions, tell your doctor about any medicines (prescription and nonprescription) you are taking and keep a diary of your AUB. Take note of:

how many tampons or pads you are using hourly or daily
how long beyond your normal period you have AUB
whether you are having clots with the bleeding
how big the clots are (the size of a nickel, a quarter, a half-dollar or larger)
whether you are spotting between periods
what days in relation to your period you have spotting
whether you bleed or have spotting after sex
whether you have pain with AUB

Eat right and exercise reasonably to maintain an appropriate weight. Weighing too much or too little can interfere with menstruation. Women who are overweight may have AUB because they store extra estrogen in their fat cells. Women who diet or exercise excessively may have so little body fat that they no longer produce enough estrogen to get periods.
Get enough sleep and try to reduce or manage stress.

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For More Information Click on the Links Below

Familydoctor.org Abnormal Uterine Bleeding
American Academy of Family Physicians Abnormal Uterine Bleeding

References

American College of Obstetricians and Gynecologists Precis, Second Edition, Reproductive Endocrinology; An Update in OB/GYN.
American College of Obstetricians and Gynecologists Guidelines For Women's Health Care, Abnormal Genital Bleeding, Page 113 to 119, 1995.
ACOG Patient Education, Abnormal Uterine Bleeding, APO95, 1996.

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Disclaimer: This content is reviewed periodically and is subject to change as new healthcare information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional