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Abnormal Uterine Bleeding: Signs, Diagnosis, and Care
Women typically experience menstrual cycles from the age of 11–12 years until around 50 years. During this 35–40 year span, it is not unusual to have a few episodes of bleeding that don’t follow the normal pattern. However, if this irregularity continues or becomes frequent, it should not be ignored. Consulting a gynecologist becomes important.
Abnormal uterine bleeding may include an increase in the number of bleeding days, heavy bleeding with clots, associated abdominal pain, or unpredictable, irregular bleeding. Normally, menstrual bleeding lasts up to 7 days. Any bleeding that is longer, heavier, or happens outside the usual cycle is considered abnormal and may need medical attention.
What is Abnormal Uterine Bleeding ?
Abnormal Uterine Bleeding (AUB) refers to any type of bleeding from the uterus that is unusual in its timing, amount, or duration. It is different from your regular monthly period. This condition can occur in women of any age — from adolescence to menopause — and may affect your daily life, health, and emotional well-being.
Bleeding is considered abnormal if:
- It happens between your periods (spotting or unexpected bleeding)
- It occurs after sexual intercourse
- You experience bleeding after menopause
- Your periods are very heavy (requiring frequent pad/tampon changes, passing large clots)
- Your periods last longer than 7 days
- You skip periods or they come too often (e.g., every 2 weeks)
- The cycle is completely unpredictable or irregular
This condition is also known by other names such as:
- Irregular menstrual bleeding
- Heavy menstrual bleeding
- Menorrhagia (excessive bleeding during periods)
- Metrorrhagia (bleeding between periods)
- Dysfunctional Uterine Bleeding (DUB)
How AUB Affects Women
Abnormal uterine bleeding is not just a physical inconvenience—it can affect your quality of life. Women with AUB may experience:
- Fatigue or weakness due to blood loss
- Anemia (low hemoglobin)
- Disruption of daily work or school life
- Emotional stress or anxiety
- Sexual discomfort or pain
- Concerns about fertility or reproductive health
When Is Bleeding Considered “Too Much”?
- Changing sanitary pads every 1–2 hours for several hours
- Bleeding that soaks through clothes or bed sheets
- Needing to use double protection (pads + tampons)
- Passing clots larger than a ₹1 coin (or 1-inch size)
- Bleeding that lasts more than 7 days
Common Symptoms of Abnormal Uterine Bleeding
Recognizing the symptoms early can help in timely diagnosis and treatment. Watch out for the following signs:
- Bleeding between menstrual periods
- Periods that last longer than 7 days
- Heavy menstrual flow (soaking through pads/tampons every hour)
- Spotting or bleeding after menopause
- Bleeding after sexual intercourse
- Very irregular menstrual cycles
- Periods coming more often than every 21 days or less often than every 35 days
If you experience any of these symptoms, it’s important to speak with a gynecologist. At Nelson Hospital, our women’s health specialists can guide you through proper evaluation and care.
It is important to consult with a healthcare provider if you experience any of the following symptoms:
- Irregular periods.
- Difficulty getting pregnant.
- Excessive hair growth or acne.
- Weight gain that is difficult to manage.
Early treatment and diagnosis can control symptoms and enhance quality of life.
What Causes Abnormal Uterine Bleeding?
AUB can have several causes. Sometimes, it’s due to a hormonal imbalance. Other times, it may be related to structural problems in the uterus or underlying medical conditions.
1. Hormonal Imbalance
- Most common in teenagers and women approaching menopause.
- Caused by irregular ovulation which affects estrogen and progesterone levels.
2. Uterine Fibroids or Polyps
- Non-cancerous growths in or around the uterus that can cause heavy bleeding or bleeding between periods.
3. Endometriosis
- A condition where the tissue that lines the uterus grows outside it, leading to pain and abnormal bleeding.
4. Polycystic Ovary Syndrome (PCOS)
- A hormonal disorder that can cause irregular periods, skipped periods, or heavy bleeding.
5. Pregnancy-related Issues
- Miscarriage, ectopic pregnancy, or other complications may cause bleeding.
6. Medications
- Blood thinners, birth control pills, or hormone therapy may trigger AUB.
7. Cancer or Precancerous Conditions
- Especially in women over 40 or post-menopause, bleeding may be a sign of endometrial or cervical cancer.
How is Abnormal Uterine Bleeding Diagnosed?
At Nelson Hospital, we follow a step-by-step approach to diagnose AUB:
1. Medical History & Physical Exam
- We begin by understanding your menstrual cycle, lifestyle, and medical history.
2. Pelvic Examination
- A physical check to identify any visible abnormalities or infections.
3. Blood Tests
- To check hormone levels, thyroid function, or rule out anemia.
4. Ultrasound
- A pelvic ultrasound helps us see the uterus, ovaries, and endometrium for fibroids, cysts, or other issues.
5. Pap Smear or Endometrial Biopsy
- In some cases, we take a small sample of uterine lining to check for cancer or infections.
6. Hysteroscopy
- A small camera is inserted into the uterus to directly view and diagnose internal problems.
Treatment Options for Abnormal Uterine Bleeding
The right treatment depends on the cause, your age, your plans for pregnancy, and overall health. Nelson Hospital offers personalized care with multiple safe and effective options:
1. Lifestyle Changes
- Weight management, stress reduction, and regular exercise can help balance hormones.
2. Medications
- Hormonal therapy (birth control pills, progesterone)
- Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce bleeding and pain
- Iron supplements if you have anemia
3. Intrauterine Device (IUD)
- A hormonal IUD can help reduce heavy menstrual bleeding.
4. Surgical Options (when necessary)
- Polyp or fibroid removal
- Endometrial ablation – destroys the uterine lining to reduce bleeding
- Hysterectomy – complete removal of the uterus (used only in severe cases)
At Nelson Hospital, we focus on minimally invasive procedures whenever possible to reduce recovery time and improve outcomes.
When Should You See a Doctor?
Please do not ignore abnormal bleeding. It can be a sign of something that needs medical attention. See a doctor if you notice:
- Bleeding after menopause
- Periods that are too heavy or painful
- Any sudden changes in your cycle
- Bleeding between periods regularly
- Bleeding after sexual intercourse
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