Abnormal uterine bleeding is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy. It reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining. The bleeding is unpredictable in many ways and it may be excessively heavy or light and may be prolonged, frequent, or random. About 1-2% of women with improperly managed ovulatory bleeding eventually may develop endometrial cancer. Uterine Bleeding should be suspected in patients with unpredictable or episodic heavy or light bleeding despite a normal pelvic examination. Typically, the usual moliminal symptoms that accompany ovulatory cycles will not precede bleeding episodes. Patients who report irregular menses since menarche may have polycystic ovarian syndrome which is characterized by anovulation or oligo-ovulation and hyper-androgenism. These patients often present with unpredictable cycles or infertility, hirsutism with or without hyperinsulinemia, and obesity.
-Hormones, such as a progestin pill or daily birth control pill help control the menstrual cycle and reduce bleeding.
-Use of the levonorgestrel IUD, which releases a progesterone-like hormone into the uterus and reduces bleeding while preventing pregnancy.
-Hysteroscopy to remove polyps or fibroids.
-Surgery, such as, endometrial ablation or hysterectomy when other treatments do not work.
If you also have menstrual pain or heavy bleeding, you can take regular doses of a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen.
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