Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) refers to any irregular bleeding from the uterus that is not part of a normal menstrual cycle. It can occur in up to 14% of women.  Here's an overview of its causes and treatment options.

Causes of Abnormal Uterine Bleeding:

1. Hormonal Imbalances:

• Menstrual cycle disorders: Conditions like polycystic ovary syndrome (PCOS) thyroid disorders, or uncontrolled diabetes can disrupt hormone levels, leading to AUB.

• Perimenopause: Hormonal fluctuations before menopause can cause irregular bleeding.

1. Structural Abnormalities:

• Uterine fibroids: Non-cancerous growths in the uterus.

• Polyps: Non-cancerous growths on the lining of the uterus.

• Adenomyosis: When the tissue that normally lines the uterus grows into the muscular walls of the uterus.

• Endometrial hyperplasia: Thickening of the uterine lining.

• Cancer: Rarely, abnormal bleeding can indicate endometrial or cervical cancer.

1. Other Factors:

• Medications: Certain medications, such as blood thinners, antipsychotics, antiepileptics, can cause AUB.

• Intrauterine devices (IUDs): Sometimes, hormonal IUDs can cause irregular bleeding.

• Pelvic inflammatory disease (PID): Infections of the reproductive organs can lead to AUB.

• Pregnancy complications: Miscarriage or ectopic pregnancy can cause abnormal bleeding.

Incidence of Abnormal Uterine Bleeding:

• AUB is a common gynecological complaint, affecting up to 14% of women of reproductive age.

• Exact incidence rates vary based on underlying causes and population demographics.

• It can occur at any point during a woman's reproductive years and sometimes during perimenopause.

Treatment of Abnormal Uterine Bleeding:

If you experience an unusual amount of bleeding during menstrual cycles or in perimenopause, you should consult a healthcare provider to determine the cause of AUB. They may perform a pelvic exam, blood tests(to check

how your blood is clotting), pregnancy tests(miscarriages can cause heavy bleeding), ultrasounds, and more to determine the underlying cause. Treatment depends on the underlying cause, severity of symptoms, and the woman's reproductive plans:

Medications:

1. Hormonal therapies: Birth control pills, hormonal IUDs, or hormonal medications can regulate menstrual cycles.

2. Nonsteroidal anti-inflammatory drugs (NSAIDs): Can help reduce heavy bleeding.

3. Non-Surgical Procedures:

• Endometrial ablation: Destroys the lining of the uterus to reduce or stop menstrual flow.

• Uterine artery embolization: Minimally invasive procedure to shrink fibroids by blocking their blood supply.

1. Surgical Options:

• Hysterectomy: Surgical removal of the uterus, considered a last resort for severe cases or when other treatments fail.

• Myomectomy: Surgical removal of fibroids while preserving the uterus.

1. Lifestyle Changes: Monitoring and Follow-Up:

• Weight management: Obesity can exacerbate hormonal imbalances leading to AUB.

• Stress reduction: Stress can affect menstrual cycles; managing stress can sometimes help regulate bleeding.

Conclusion:

Abnormal uterine bleeding can significantly impact a woman's quality of life and may indicate underlying health issues. Evaluation by a healthcare provider is essential for accurate diagnosis and appropriate management tailored to the individual's needs.  With the right care, women can take more proactive steps to maintain their overall health.