Abnormal uterine bleeding is the condition where irregular bleeding from the uterus takes place. The bleeding is heavier or lighter than usual and occurs for a longer duration and is the cause of much distress. It can occur at any time of the monthly cycle of a woman and even occur during the normal menstrual period. However, abnormal uterine bleeding does not occur during pregnancy. Bleeding during pregnancy occurs due to other causes.
One of the symptoms of this disorder is bleeding from the vagina in between periods. Abnormal uterine bleeding (AUB) can also result in extremely heavy bleeding during the periods. If extreme bleeding occurs for more than 7 days during periods or otherwise, the condition is known as menorrhagia. AUB can occur due to polyps or fibroids, which are irregular growths in the uterus. Some other causes of AUB can include infection in the cervix, a thyroid problem or a cancer of the uterus. Another cause for abnormal uterine bleeding is hormone imbalance. When abnormal bleeding occurs due to hormonal imbalance, the condition is called dysfunctional uterine bleeding. Teenagers and women, who are approaching menopause, are more susceptible to dysfunctional uterine bleeding.
The treatment for abnormal uterine bleeding depends on age, the cause of the bleeding and whether the person wants to get pregnant in the future or not. However, the different treatment options include use of an intrauterine device, birth control pills, D&C or dilatation and curettage, endometrial ablation and hysterectomy.
IUD or intrauterine device is a small, plastic device that is inserted into the uterus through the vagina of a woman getting treated. The IUD releases hormones that help to reduce abnormal bleeding. Another way to prevent abnormal bleeding is by using birth control pills. They prevent the lining of the uterus from getting too thick and also help to regularize the menstrual cycle and even reduces cramping.
Another effective method of treating abnormal uterine bleeding is the D&C or dilatation and curettage procedure. In this method, the opening of the cervix is stretched so that a surgical tool can be inserted into the uterus. The lining of the uterus is scraped away with the help of this tool. The doctor then checks the removed lining for any abnormality and to determine the cause of the abnormal bleeding. D&C is performed to find out the cause of bleeding and also to address it in patients who suffer from heavy bleeding from the uterus.
Hysterectomy is a surgical procedure whereby the uterus is removed. It does not allow the patient to have any more periods and does not allow her to get pregnant. It is normally performed under general anesthesia and requires a person to stay at a hospital.
Endometrial ablation does not remove the uterus but destroys the lining of the uterus. All types of menstrual bleeding are halted as a result of the procedure.
A person is eligible for treatment if she experiences some or all of the symptoms associated with abnormal uterine bleeding. Some of the symptoms are spotting or bleeding from the vagina between periods, frequent or irregular periods, and heavier bleeding due to large clots. A person may suffer from AUB if the bleeding lasts for more than seven days or for a period longer than what is normal. AUB may also occur due to hormonal imbalance. The symptoms associated with hormonal imbalance include excessive growth of body hair, mood swings, hot flashes and dryness and tenderness of the vagina.
A person is eligible for surgical procedures only if she is suffering from a serious condition and if she has not experienced any tangible benefits from medications. However, a person will only be eligible for treatment if she experiences some or all of the symptoms associated with AUB and has been properly diagnosed by a doctor.
The side-effects associated with dilation and curettage treatment are foul-smelling discharge from the vagina, abdominal pain, heavy bleeding and fever accompanied with chills. A person undergoing hysterectomy may experience a number of side-effects including clotting of blood in the legs or lungs, heavy bleeding, infection, injury to the organs that are located nearby and she may also experience pain during sexual intercourse. Endometrial ablation entails a frequent urge for urination in the first 24 hours, menstrual cramps for a couple of days, discharge of a thin, watery fluid mixed with blood and feeling of nausea.
A woman will generally recover from the effects of endometrial ablation within a week or so. However, a doctor might advise her to refrain from any strenuous activities and also lifting any weights. She will also stop having sex and using sanitary napkins for the time being. A person requires at least 4-6 weeks to recover from hysterectomy. In this case too, a person is advised not to indulge in any strenuous activities and not to lift any weights. Any type of treatment undertaken for abnormal uterine bleeding requires a regular follow-up with the doctor and adherence to the guidelines that are recommended.
It takes about 4-6 weeks for a woman to resume with her normal activities after hysterectomy. A person undergoing endometrial ablation will take a week to recover. A person will take some time to recover if she has undergone the dilation and curettage treatment. The doctor may advise her to avoid having sex, or not to use douche or tampons.
The cost of hysterectomy in India varies from Rs 1, 80,000 to Rs 2,20,000. Installing an intrauterine device can cost something around Rs 10000 in our country. Endometrial dilation is expensive and the average price of the procedure is close to Rs 2, 00,000. However, in some cases, it can go up to more than Rs 3,50,000.
Hysterectomy and endometrial ablation are surgical procedures that require the complete or partial removal of the uterus. These treatments may prove to be a permanent solution for abnormal uterine bleeding problem. However, the dilation and curettage treatment may not always provide permanent results. The bleeding may start again if there is any problem in the uterus. Birth control pills are used to prevent the wall of the uterus from getting heavy. However, this is not a permanent solution as the bleeding might resume once a patient is off the pills.
A person suffering from abnormal uterine bleeding should incorporate foods like whole grains, fresh ripe fruits and fresh vegetables and fish like sardines and tuna so that her body receives the required nourishment. Adequate intake of foods rich in iron is required to deal with this condition. Ginger has well-known healing properties and helps to deal with the excessive bleeding from the uterus. Furthermore, hemostat agent therapy can be used to treat people suffering from dysfunctional uterine bleeding.
Rs 10,000 to Rs 3,50,000
The cycle changes and the bleeding become heavier.
Bleeding lasts for 7 days or more.
A tender or dry vagina.
Abnormal mood swings.
Excessive body hair, especially on the back, chest and face.
The ovaries do not release an egg.
Changes in the hormone level.
Lower levels of oestrogen or progesterone.
Thickening of the uterine wall in women above 40 years of age.
Certain birth control pills can also cause abnormal bleeding.
Some women also complain of abnormal bleeding in their first few weeks of pregnancy.
The physician first checks the haemoglobin levels of the woman.
An ultrasound of the pelvic region is done to check for physical injuries.
Sometimes, an endometrial biopsy (the doctor checks a sample of the endometrium, which is the lining of the uterus) is also used to test the condition of the uterine lining.
Hysteroscopy, using a hysteroscope, is used to test the insides of the uterus. A hysteroscope is a thin tube that is inserted into the vagina for the examination of cervix as well as the insides of the uterus.
Younger women in the range of 18-23 years of age are usually treated using low doses of birth control pills.
Oestrogen therapy is used.
Painkillers such as ibuprofen are also prescribed before the beginning of the menstrual periods.
The increase of ‘progesterone’ through IUD. An IUD (intrauterine device) is a contraceptive device that is inserted into the uterus.
Cyclic hormone therapy is given to women above 40 years of age (Progesterone is administered in a periodic interval, usually about 4 weeks).
Women considering pregnancy are recommended hormone therapy to increase ovulation.
Are you experiencing abnormal uterine bleeding? The term Abnormal uterine bleeding is used when the menstrual period doesn't conform to normal pattern. Any menstrual cycle, which has interval of less than 21 days or longer than 35 days, the duration is less than 2 days or more than 7 days, the flow is more or less than normal and there is bleeding apart from the menstrual period is an abnormal form of uterine bleeding.
Causes of Abnormal Uterine Bleeding:
The various causes of abnormal uterine bleeding are as follows:
Treatment of abnormal uterine bleeding, depends upon the cause of bleeding and the patient’s age.
In case of abnormal uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.
In case you have a concern or query you can always consult an expert & get answers to your questions!
It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.
The following are considered to be abnormal or dysfunctional uterine bleeding:
What can cause such a situation?
Some of the common causes leading to abnormal bleeding are as follows:
How to Diagnose it?
Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.
How Best to Treat It?
This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways. If you wish to discuss any specific problem, you can consult a gynaecologist.
Any kind of bleeding from the uterus, which is not normal, can be termed as abnormal uterine bleeding. This refers to bleeding between periods or before periods, bleeding after having sex, spotting, abnormally heavy bleeding or bleeding after attaining menopause. If you are suffering from any of these issues, you need to check with the doctor.
It is very important to diagnose abnormal uterine bleeding. There are several examinations and tests that have to be carried out, depending on age. For irregular spotting, a pregnancy test can be undertaken in case you think you could be pregnant. If your uterine bleeding is very heavy, a test has to be performed to check blood count. This is done to observe whether you have anemia. An ultrasound test of the pelvic region will also be advised by your doctor to know the cause of the bleeding. Several hormonal tests and thyroid function tests are required as well.
Other diagnostic tests include:
Abnormal uterine bleeding is a serious health condition, which may lead to severe complications. Immediate diagnosis and appropriate treatment methods should be undertaken in case of any abnormal uterine bleeding.
Abnormal uterine bleeding, also known as AUB, is one of the most common causes requiring gynecologic evaluation. Hysteroscopy is a procedure wherein a thin camera called hysteroscope is introduced into the uterus via the vagina and this light helps in a thorough examination of the uterus. In cases where there are cysts or fibroids or even cancerous growths, this is used to get more details on the lesions. However, hysteroscopy also has a therapeutic use in that it is used to treat conditions like abnormal uterine bleeding. Read on to know more about AUB and how hysteroscopy helps in treatment.
Causes of Abnormal Uterine Bleeding: Vaginal bleeding that occurs more often than 21 days and farther apart than 35 days is known as abnormal uterine bleeding. The bleeding is also abnormal if it lasts longer than 7 days and more than 80 mL of blood is lost during each cycle.
Some causes include:
When a woman has abnormal bleeding, further diagnosis is required to confirm the exact cause of the bleeding. This is where the hysteroscopy comes into the picture. Hysteroscopy, literally translates to viewing the uterus from inside directly through a camera.
How it is done:
Hysteroscopy is done as an outpatient procedure and normally takes about 3 to 4 hours. General or spinal anesthesia may be used depending on complexity and overall patient health. The uterus is filled with a fluid like saline or glycerin and a thin lighted instrument called the hysteroscope is inserted through the vagina, up the cervix, and into the uterus. This tube is flexible and so can be moved across the uterus to identify any areas of abnormality. It also has a camera and so can be used to take pictures of suspicious areas.
Causes for infertility may also be detected using hysteroscopy. Small knives can also be used to remove the lesion like fibroid or polyp. These are often the cause of abnormal bleeding. Samples can also be taken for biopsy to confirm if any cancerous growth is detected.
Hysteroscopy is a safe and effective way to examine the cervical canal and uterine cavity. It is better to accompany D&C with hysteroscopy instead of going for blind dilatation and curettage, especially in women who are peri or premenopausal. Hysteroscopy is a safe procedure if done by a doctor, specialised in gynecological endoscopy and helps in both diagnosis and treatment of abnormal uterine bleeding.