Abnormal menstrual bleeding (AUB) is a common term encompassing variations in menstrual cycle frequency, duration, and amount of bleeding. It can manifest in various ways, and understanding the specific type of AUB you're experiencing can help navigate towards appropriate diagnosis and management.
1. Types of AUB
- Heavy menstrual bleeding (menorrhagia): Excessive bleeding, typically with periods lasting longer than 7 days or requiring frequent changes of sanitary pads/tampons.
- Prolonged menstrual bleeding (metrorrhagia): Irregular bleeding or spotting between periods.
- Frequent menstrual bleeding (polymenorrhea): Periods occurring closer together than 21 days apart.
- Scanty menstrual bleeding (hypomenorrhea): Light or short periods lasting less than 2 days.
- Absence of menstrual bleeding (amenorrhea): Missed periods, which can be primary (never having had periods) or secondary (periods stopping after having started).
2. Causes of AUB
Various factors can contribute to AUB, including:
- Hormonal imbalances: Hormonal fluctuations due to puberty, perimenopause, menopause, thyroid disorders, or polycystic ovary syndrome (PCOS) can impact bleeding patterns.
- Uterine fibroids, polyps, or adenomyosis: These benign growths or thickening of the uterine lining can cause heavy or irregular bleeding.
- Pelvic inflammatory disease (PID): Infection of the female reproductive organs can disrupt menstrual cycles.
- Endometriosis: Tissue similar to the uterine lining growing outside the uterus can lead to painful and irregular bleeding.
- Blood clotting disorders: Some conditions affecting blood clotting can cause heavier or prolonged bleeding.
- Medications: Certain medications, like anticoagulants or hormone therapy, can alter menstrual patterns.
- Stress, weight changes, and other lifestyle factors: These can also influence hormone levels and affect bleeding.
3. Diagnosis
Diagnosing AUB often involves a combination of:
- Medical history and physical exam: Evaluating symptoms, risk factors, and overall health.
- Pelvic ultrasound: Checking for structural abnormalities in the uterus or ovaries.
- Blood tests: Measuring hormone levels and ruling out underlying medical conditions.
- Endometrial biopsy: In some cases, a small tissue sample from the uterine lining is examined for abnormalities.
4. Treatment Options
Treatment options for AUB depend on the underlying cause and severity of symptoms. Possibilities include:
- Lifestyle modifications: Managing stress, maintaining a healthy weight, and regular exercise can sometimes improve bleeding patterns.
- Hormonal therapy: Birth control pills, progestin therapy, or other hormonal medications can regulate menstrual cycles and reduce bleeding.
- Minimally invasive procedures: Endometrial ablation or myomectomy (fibroid removal) can be performed through laparoscopy or hysteroscopy in certain cases.
- Surgery: Hysterectomy may be considered for severe AUB unresponsive to other treatments or for women who have completed childbearing.
5. Living with AUB
- AUB can be uncomfortable and disruptive, but it's important to remember that it's a common condition with solutions available. Open communication with your doctor, seeking a timely diagnosis, and managing the condition effectively can help improve your quality of life.
- Remember, you're not alone. AUB affects many women, and resources are available to help you manage your symptoms and access appropriate care. Don't hesitate to reach out to your doctor if you're experiencing abnormal menstrual bleeding, and trust that with the right approach, you can navigate this challenge and maintain your well-being.
