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Abnormal (Dysfunctional) Uterine Bleeding
WHAT YOU NEED TO KNOW:
What is abnormal uterine bleeding (AUB)?
AUB is uterine bleeding that is not usual for you. It may also be called dysfunctional uterine bleeding. You may have bleeding from your uterus at times other than your normal monthly period. Your monthly periods may last longer or shorter, and bleeding may be heavier or lighter than usual. AUB can be acute (lasting a short time) or chronic (lasting longer than 6 months).
What causes AUB?
The following can cause or increase your risk for AUB:
- Age 40 or older, or 14 or younger
- Too much or too little estrogen
- An ovary does not release an egg during ovulation
- A medical condition, such as polycystic ovary syndrome (PCOS), diabetes, or long-term liver or kidney disease
- Not giving birth
- A growth, such as a tumor or a polyp
- Trauma such as an injury to your uterus or cervix
- An infection such as a sexually transmitted infection
- An overactive or underactive thyroid or adrenal gland
- An eating disorder, such as bulimia or anorexia, or too much exercise
- Certain medications, or hormone replacement therapy
- A large weight gain or loss
What are the signs and symptoms of AUB?
- Bleeding or spotting between periods
- Bleeding that starts 12 months or longer after you have been through menopause
- The amount of bleeding during your period is heavier or lighter than usual
- The number of days that you bleed during your regular period is longer than usual, or more than 7 days
- The number of days that you bleed is shorter than usual, or less than 2 days
- The time between your monthly periods is shorter or longer than usual
How is AUB diagnosed?
Your healthcare provider will ask about your monthly periods. Tell him or her about all changes to your periods. Include when the changes started. Your provider may ask the age you were when you got your first period. He or she may ask if you use tampons or sanitary pads. Tell him or her about any medical conditions you have and all medicines you currently use. You may need any of the following, depending on your age and medical history:
- Blood tests may be done to find the cause of your AUB and problems caused by AUB, such as anemia. Your provider may recommend screening for an STI as part of the blood tests.
- A pelvic exam may be done to find the source of your bleeding.
- A hysteroscopy is a procedure to look at your endometrium. The endometrium is the lining inside of your uterus. Your healthcare provider will insert a small tube with a camera at the end into your uterus.
- A biopsy is a procedure to remove a small piece of tissue from the endometrium. The tissue is sent to a lab for tests.
- An ultrasound uses sound waves to show pictures of your uterus, ovaries, tubes, and vagina on a monitor.
- A pap smear may be needed. Your healthcare provider takes a sample of tissue from your cervix and sends it to a lab for tests.
How is AUB treated?
- Medicines may be given to treat a condition causing AUB. An example is medicine to increase or decrease the amount of hormone your thyroid makes. Hormones may be given to help decrease bleeding by making your monthly periods more regular. Sometimes this medicine may be given as birth control pills. Iron supplements may be given if your blood iron level decreases because of heavy bleeding.
- Procedures such as endometrial ablation or dilation and curettage may be used to control your bleeding.
- Surgery may be needed if medicines do not work or cannot be used. You may need an abdominal or vaginal hysterectomy. A hysterectomy is surgery to remove your uterus.
How do I care for myself at home?
- Include foods high in iron if needed. Examples of foods high in iron are leafy green vegetables, beef, pork, liver, eggs, and whole-grain breads and cereals.
- Keep a diary of your menstrual cycles. Keep track of the number of tampons or pads you use each day.
- Talk to your healthcare provider before you start a weight loss program. You may need to wait until the abnormal bleeding has stopped before you try to lose weight. The amount of iron in your blood should be normal before you lose weight. Ask your provider if weight loss will help your AUB. He or she can tell you what weight is healthy for you. He or she can help you create a safe weight loss plan, if needed.
When should I seek immediate care?
- You continue to bleed heavily, or you feel faint.
When should I call my doctor or gynecologist?
- You need to change your sanitary pad or tampon more than 1 time each hour.
- Your medicine causes nausea, vomiting, or diarrhea.
- You have questions or concerns about your condition or care.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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