Abnormal uterine bleeding (AUB) is a broad phrase referring to abnormalities in the menstrual cycle outside of pregnancy. Up to one out of three women will develop abnormal uterine bleeding at menarche (the first occurrence of menstruation) or perimenopause (when a woman becomes less fertile, hormones fluctuate). A normal menstrual cycle lasts 2 to 7 days and bleeds 5 to 80 milliliters. Abnormal uterine bleeding occurs when any of these four parameters change.
Abnormal uterine bleeding affects 3% to 30% of reproductive-aged women globally, with a higher incidence around menarche and perimenopause. When irregular and intermenstrual bleeding are included, the prevalence climbs to 35% or more.
There are multiple reasons for AUB, including hormonal imbalances, structural abnormality of the uterus, cancer, infections, and other medical conditions.
Hormonal imbalance includes:
Structural abnormalities in the uterus include:
Types of cancer and precancer include:
There are several abnormal signs of uterine bleeding. Below are a few signs that a woman might be bleeding unusually:
Doctors will perform a pelvic examination. They will also request lab tests such as a complete blood count (CBC) to detect anemia and infections. Importantly, bleeding disorders must be tested. Lastly, doctors will also request pregnancy tests and tests for sexually transmitted diseases (STDs).
Depending on the age and symptoms, a woman experiencing AUB may need the following:
Medications and surgery can stop or treat bleeding.
Some of the medicines used to stop abnormal uterine bleeding are:
Some of the surgery done to address AUB are:
Many things can cause uncontrollable bleeding in the uterus, but lowering the chances of getting some conditions that cause abnormal bleeding is still possible. For example, keeping a normal weight could help keep hormones in balance. Some types of cancer are less likely to happen if the diet has less animal fat. Having safe sex will make you less likely to get certain sexually transmitted infections (STIs) that can cause the uterus to bleed.
It is also essential that women report to their physician when they experience abnormal bleeding and openly discuss menstruation with them. Such open conversation would help the physician identify obvious signs and inform their patients what should be done.
Davis E, Sparzak PB. Abnormal Uterine Bleeding. [Updated 2022 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532913/
The American College of Obstetricians and Gynecologist (2022). Abnormal Uterine Bleeding. Retrieved November 1, 2022, from https://www.acog.org/womens-health/faqs/abnormal-uterine-bleeding
Cleveland Clinic (2022). Abnormal Uterine Bleeding. Retrieved November 1, 2022, from https://my.clevelandclinic.org/health/diseases/15428-uterine-bleeding-abnormal-uterine-bleeding#symptoms-and-causes