What is a normal menstrual cycle?
The average age when a girl starts menstruating is between the age of 11 to 14 years of age. A normal menstrual cycle varies from 24 to 38 days approximately. Any change from the above parameters, at any age, is called abnormal uterine bleeding and needs to be investigated.
What is abnormal uterine bleeding?
Any bleeding which occurs outside these parameters and is different from the normal cycle for a woman is considered abnormal e.g.
- Irregular, heavy, or intermenstrual bleeding in young girls
- Heavy bleeding during periods
- Bleeding after menopause
- Bleeding in between periods
- Bleeding after sexual intercourse
- Cycles shorter than 24 days and longer than 38 days approximately
- Irregular cycles
What can be the causes of abnormal uterine bleeding?
There can be several causes for the abnormal bleeding.
- It can be the first sign of a miscarriage
- It may be due to an ectopic pregnancy in which the pregnancy starts to grow in the fallopian tube and has not reached the uterus. This can be dangerous and needs to be diagnosed early so that it can be managed without surgerOther causes
- In young girls while the hormonal axis is maturing ther may be abnormal patterns of bleeding
- Disturbances in ovulation and can lead to infertility
- Can be due to fibroids and polyps in the uterus
- Can be due to sexually transmitted disease
- Can be due to cancer of the uterus or the cervix
- Adenomyosis and endometriosis can also cause abnormality in the cycles
- Problems with the birth control methods used
- Bleeding disorders may also lead to abnormal bleeding
- Associated conditions like thyroid disorders and diabetes and high blood pressure may also contribute to abnormal bleeding
- Using unsupervised medication for emergency contraception and other hormone tablets can lead to disruption of your normal cycles.
What should you do?
If you have any of the symptoms described above you should consult a gynaecologist and get a thorough check-up.
What will happen at the doctor’s visit?
Your gynaecologist will take a detailed history of your symptoms, your past cycles, your past medical history and other details regarding your health.
After this, you will be advised to undergo certain tests.
What tests will be needed?
You will require the following tests:
- Clinical Examination
- Blood tests
- Ultrasound scan
- Pap Smear
- May require CT scan or MRI ( your doctor will guide you appropriately)
- Hysteroscopy – In this, a narrow scope with a light is inserted into the uterine cavity to diagnose the cause of the bleeding and it may be possible to treat it at the same time.
- Endometrial Biopsy will be taken. Sometimes it may be taken in the Outpatient also.
What is the treatment for Abnormal Uterine bleeding?
The treatment will depend upon the cause of abnormal bleeding.
- If the bleeding is caused by a pregnancy the management will depend upon the condition of the pregnancy and its site.
- You may require antibiotics if there is any infection.
- Hormonal tablets to regularise the cycles
- Medicines to stop your bleeding – haemostatics.
- Hormone laden intra uterine contraceptive devices.
- Tablets to correct the thyroid dysfunction
- Dilation and curettage
- Ablation of the uterine lining
- Cervical cauterisation if needed
- Uterine artery embolization
- Removal of the uterus by laparoscopy or conventional method
Caution: Do not ignore any abnormal bleeding.
It may be the cause of a serious medical problem. It should be investigated and treated accordingly. On should not try self-medication.
Women do not have to suffer from abnormal bleeding no matter what the age. There is the treatment for all conditions.