Abnormal Uterine Bleeding

What is abnormal uterine bleeding?

Abnormal uterine bleeding is very common. Types of abnormal uterine bleeding include: bleeding (spotting) between periods, bleeding after sex, heavy bleeding which lasts for more than 7 days in the menstrual cycle, and bleeding after menopause.

What causes abnormal uterine bleeding?

There are many potential causes of abnormal uterine bleeding, including:

• pregnancy
• fibroid tumours
• endometrial/uterine polyp or cancer
• hormonal imbalance
• miscarriage
• ectopic pregnancy
• polycystic ovarian syndrome (PCOS)
• endometriosis
• cancer of the cervix or vagina
• birth control measures such as oral pills or intrauterine device (IUD)

How is the cause of abnormal uterine bleeding diagnosed?

A diagnosis of the cause of uterine bleeding is made after a medical history is taken and physical examination and tests are performed.

Tests may include:

• pregnancy test: to confirm whether you are pregnant
• pelvic ultrasound: an imaging test that uses high-frequency sound waves to create pictures of the female pelvic organs
• endometrial biopsy: a procedure to take cells from the lining of the uterus (endometrium) to check for any abnormalities
• hysteroscopy: a minor and fairly safe surgical procedure used for diagnosis and/or treatment of various conditions of the uterus. In this procedure, a thin magnifying instrument called a hysteroscope is inserted into the uterus through the vagina to view the internal structures. The camera in the hysteroscope displays the images on a monitor thereby helping the surgeon to view the internal structures.

How is abnormal uterine bleeding treated?

The treatment plan for uterine bleeding depends on the cause as well as a number of other factors, such as your age and whether you are planning to become pregnant.

The treatment options may include:

• birth control pills: to help maintain regular periods
• an intra-uterine device (IUD):  a birth control device that is inserted in the uterus which can control the release of hormones
• dilatation and curettage (D&C): a surgical procedure in which the cervix is expanded with a dilator and the tissue lining the uterus (endometrium) is sampled with a curette