ABNORMAL UTERINE BLEEDING – CAUSES & TREATMENT

February 13, 2019admin Women Health bleeding menstrual cycle period uterine uterine bleeding 1

We have to understand “what normal menstrual cycle is”, before discussing the abnormal one.

The normal length of the menstrual cycle is typically between 21 days and 35 days. A normal menstrual period generally lasts up to 8 days.

Anything otherwise can be regarded as Abnormal Uterine bleeding.

What Abnormal uterine bleeding is:

Bleeding or spotting between periods
Bleeding or spotting after s*x
Heavy bleeding during your period
Menstrual cycles that are longer than 38 days or shorter than 24 days
“Irregular” periods in which cycle length varies by more than 7–9 days
Bleeding after menopause

At what ages is abnormal bleeding more common?

Abnormal bleeding can occur at any age. However, at certain times in a woman’s life it is common for periods to be somewhat irregular. Periods may not occur regularly when a girl first starts having them (around age 9–14 years). During perimenopause (beginning in the mid–40s), the number of days between periods may change. It also is normal to skip periods or for bleeding to get lighter or heavier during perimenopause.

THE CAUSES OF ABNORMAL UTERINE BLEEDING ARE:

Problems with ovulation
Fibroids and polyps
A condition in which the endometrium grows into the wall of the uterus
Bleeding disorders
Problems linked to some birth control methods, such as an intrauterine device (IUD) or birth control pills
Miscarriage
Ectopic pregnancy
Cancers of the cervix or that of the lining of the womb(endometrium)

How is abnormal bleeding diagnosed?

Your ob-gyn or other health care professional will ask about your health history and your menstrual cycle. It may be helpful to keep track of your menstrual cycle before your visit. Note the dates, length, and type (light, medium, heavy, or spotting) of your bleeding on a calendar. You also can use a smartphone app designed to track menstrual cycles.

You will have a physical exam. You also may have blood tests. These tests check your blood count and hormone levels and rule out some diseases of the blood. You also may have a pregnancy test and tests for sexually transmitted
infections (STIs).

The following tests are carried out to find out the possible cause of abnormal uterine bleeding:

Ultrasound exam—Sound waves are used to make a picture of the pelvic organs.
Hysteroscopy—A thin, lighted scope is inserted through the vagina and the opening of the cervix. It allows the doctor to see the inside of the uterus.
Endometrial biopsy—A sample of the endometrium is removed and looked at under a microscope.
Sonohysterography—Fluid is placed in the uterus through a thin tube while ultrasound images are made of the inside of the uterus.
Magnetic resonance imaging (MRI)—An MRI exam uses a strong magnetic field and sound waves to create images of the internal organs.
Computed tomography (CT)—This X-ray procedure shows internal organs and structures in cross section.

TREATMENT OF ABNORMAL UTERINE BLEEDING:

Medications often are tried first to treat irregular or heavy menstrual bleeding. The medications that may be used include the following:

Hormonal birth control methods—Birth control pills, the skin patch, and the vaginal ring contain hormones. These hormones can lighten menstrual flow. They also help make periods more regular.
Gonadotropin-releasing hormone (GnRH) agonists—These drugs can stop the menstrual cycle and reduce the size of fibroids.
Tranexamic acid—This medication treats heavy menstrual bleeding.
Nonsteroidal anti-inflammatory drugs—These drugs, which include ibuprofen, may help control heavy bleeding and relieve menstrual cramps.
Antibiotics—If you have an infection, you may be given an antibiotic.
Special medications—If you have a bleeding disorder, your treatment may include medication to help your blood clot.

Surgical treatment is sought, if medications fail to arrest the abnormal uterine bleeding

There are different types of surgery depending on your condition, your age, and whether you want to have more children.

Hysteroscopic excision/morcellation of endometrial polyps and fibroids are employed.

The procedure is done via the v*gin*l route with the aid of operative hysteroscope.

The procedure does not require cutting the tummy open.

Laparoscopy could also be used to treat fibroids that are in the uterine wall or outside.

Open surgery is an option, where feasible.

Uterine artery embolization can also be used to treat fibroids. This procedure blocks the blood vessels to the uterus, which in turn stops the blood flow that fibroids need to grow.

Hysterectomy, the surgical removal of the uterus, is used to treat some conditions or when other treatments have failed. Hysterectomy also is used to treat endometrial cancer. After the uterus is removed, a woman can no longer get pregnant and will no longer have periods.