Abnormal Uterine Bleeding

Abnormal uterine bleeding, previously termed menometrorrhagia, can be a distressing experience for many individuals. From heavy menstrual flow to bleeding between periods, it can disrupt daily life and indicate underlying health issues. Dr. Sunita Arora, a trusted Obstetrician, Gynecologist, and Fertility Specialist based in Delhi, will help you into the intricacies of abnormal uterine bleeding, exploring its causes, symptoms, and available treatments.

What Constitutes Abnormal Uterine Bleeding?

Abnormal uterine bleeding refers to bleeding that occurs between monthly periods or during periods characterized by excessive heaviness or prolonged duration. A normal menstrual cycle typically lasts about five days and repeats every 21 to 35 days. Any deviation from this pattern warrants the attention of Dr. Sunita Arora. While some causes of abnormal bleeding may be benign, others could signal severe conditions, including cancer or fertility-related issues.

Menorrhagia and Menometrorrhagia

Previously, menorrhagia and menometrorrhagia were used interchangeably, which was confusing. Menorrhagia denotes excessive or prolonged menstruation, while menometrorrhagia encompasses irregular bleeding unrelated to menstruation. Menorrhagia is now referred to as heavy menstrual bleeding, while menometrorrhagia is known as abnormal uterine bleeding.

At What Stage of Life Do Women Typically Encounter Abnormal Uterine Bleeding?

Abnormal uterine bleeding is frequently observed in adolescent girls upon the onset of menstruation and in women approaching their mid-40s nearing menopause. Essentially, it is most prevalent at the commencement and conclusion of the reproductive phase.

Who is Affected by Abnormal Uterine Bleeding?

Abnormal uterine bleeding primarily impacts non-pregnant individuals in their reproductive years, although it can also occur in post-menopausal or pregnant individuals. Bleeding after menopause or during pregnancy warrants immediate medical attention, as it could signify underlying severe issues, including cancer. The prevalence of abnormal uterine bleeding ranges from 10% to 35% globally, with higher occurrences during menarche and perimenopause.

Abnormal Uterine Bleeding Symptoms and Causes

The symptoms of abnormal uterine bleeding vary but commonly include:

• Heavy menstrual bleeding,
• Bleeding between periods,
• Prolonged periods, and
• Irregular menstrual cycles.

Numerous factors can contribute to abnormal bleeding, including hormonal imbalances, structural abnormalities in the uterus, precancerous or cancerous conditions, infections, medical conditions, medications, and trauma.

Most conditions leading to abnormal uterine bleeding can manifest at any stage of life, although certain occurrences are more prevalent during specific periods in a woman's life.

Abnormal Uterine Bleeding in Young Girls: Bleeding preceding menarche (the onset of a girl's first period) is invariably abnormal. It could stem from various factors such as trauma, the presence of a foreign object (like toys, coins, or toilet tissue), irritation of the genital area (due to bubble baths, soaps, lotions, or infection), or urinary tract issues. Additionally, bleeding might occur as a consequence of sexual abuse.

Adolescents: Many young girls experience episodes of irregular bleeding in the initial months following their first menstruation, indicating irregular ovulation. Typically, such irregular bleeding resolves spontaneously as hormonal cycles and ovulation stabilize. However, persistent irregular bleeding or heavy bleeding necessitates further evaluation.

Abnormal Bleeding in Teens: It can also be triggered by any conditions affecting bleeding in all premenopausal women, including pregnancy, infections, bleeding disorders, or other medical ailments. These and other potential causes are elaborated on in the subsequent section.

Premenopausal Women: A range of factors can prompt abnormal bleeding in women from adolescence to menopause. Sudden hormonal fluctuations during ovulation can result in vaginal spotting or minor bleeding. Likewise, premenopausal women utilizing hormonal birth control methods may experience erratic or unpredictable bleeding.

Some Women Exhibit Irregular Ovulation Patterns: It can lead to sporadic light or heavy vaginal bleeding. Although irregular ovulation is more commonly observed during menarche and perimenopause, it can occur at any juncture throughout the reproductive years.

Additional factors contributing to abnormal uterine bleeding in premenopausal women encompass:

• Pregnancy
• Cervical or endometrial cancer or precancerous conditions affect these areas. (Endometrial cancer diagnosis, staging, and surgical treatment)
• Cervical or endometrial infection or inflammation.
• Clotting disorders include anticoagulant medications, von Willebrand disease, platelet abnormalities, or clotting factor deficiencies.
• They are underlying medical conditions like hypothyroidism, liver disease, or chronic renal insufficiency.

Determining if It’s Abnormal Uterine Bleeding

Specific indicators may suggest irregularity.

An influential gauge is the 1-10-20 test:

• If you require more than one sanitary pad or tampon per hour.
• If your menstrual period extends beyond ten days.
• If the interval between your periods is less than 20 days.

Should you observe any of these signs, it's advisable to contact Dr. Sunita Arora. Additionally, bleeding between periods or post-coital bleeding may also signify abnormal uterine bleeding.

Diagnosis and Tests

Diagnosing abnormal uterine bleeding involves a comprehensive evaluation by Dr. Sunita Arora, Obstetrician, Gynecologist, and Fertility Specialist in Delhi.

This typically includes a physical examination, pelvic and cervical exams, and various tests such as pregnancy tests, blood tests, thyroid tests, hormone level tests, hysteroscopic exams, pelvic ultrasounds, and endometrial biopsies.

Management and Treatment of Abnormal Uterine Bleeding

Treatment for abnormal uterine bleeding depends on the underlying cause. Medications such as hormonal contraceptives, progestin, NSAIDs, and GnRH agonists or antagonists may be prescribed. Surgical options, including hysteroscopy, uterine artery embolization, myomectomy, endometrial ablation, or hysterectomy, may be considered in severe cases or when conservative treatments fail.

Are Complications Possible With Abnormal Uterine Bleeding?

Abnormal Uterine Bleeding is transient, resolving once sex hormone levels normalize, thereby alleviating abnormal bleeding.

Anemia is a primary concern associated with excessive bleeding. If anemia develops due to substantial blood loss, Dr. Sunita Arora may prescribe mineral and vitamin supplements. In rare instances characterized by severe blood loss from prolonged bleeding, a blood transfusion may be necessary.

Prevention

While specific causes of abnormal uterine bleeding cannot be prevented, adopting a healthy lifestyle, maintaining a balanced weight, avoiding diets high in animal fats, practicing safer sex to prevent STIs, and seeking prompt medical attention for abnormal symptoms can reduce the risk of developing this condition.

Conclusion

Abnormal uterine bleeding is a common concern worldwide. Still, it can be minimized with timely diagnosis and appropriate treatment by Dr. Sunita Arora, an Obstetrician, Gynecologist, and Fertility Specialist in Delhi. It's crucial to prioritize reproductive health and seek medical guidance for any irregularities in menstrual patterns or abnormal bleeding episodes. Individuals can take proactive steps toward managing their health effectively by understanding the causes, symptoms, and available treatments for abnormal uterine bleeding.