Is this topic for you?
This topic is for women who want to learn about or have been diagnosed with abnormal uterine bleeding (AUB). Abnormal uterine bleeding has several causes. If you don't know what kind of bleeding you have, see the topic Abnormal Vaginal Bleeding.
What is abnormal uterine bleeding?
Abnormal uterine bleeding (AUB) is irregular bleeding from the uterus that is longer or heavier than usual or does not occur at your regular time. For example, you may have heavy bleeding during your period or in between periods.
What causes abnormal uterine bleeding?
Abnormal uterine bleeding has many causes. It is sometimes caused by changes in hormone levels. It can also be caused by problems such as growths in the uterus or clotting problems.
In some cases the cause of the bleeding isn't known.
What are the symptoms?
You may have abnormal uterine bleeding if you have one or more of the following symptoms:
- You get your period more often than every 21 days or farther apart than 35 days. A normal adult menstrual cycle is 21 to 35 days long. A normal teen cycle is 21 to 45 days.
- Your period lasts longer than 7 days (normally 4 to 6 days).
- Your bleeding is heavier than normal. If you are passing blood clots and soaking through your usual pads or tampons each hour for 2 or more hours, your bleeding is considered severe and you should call your doctor.
How is abnormal uterine bleeding diagnosed?
Before your doctor finds the cause of abnormal uterine bleeding, he or she must first make sure it's not vaginal bleeding from pregnancy or miscarriage.
Your doctor will ask how often, how long, and how much you have been bleeding. You may also have a pelvic exam, urine test, blood tests, and possibly an ultrasound. These tests will help your doctor check for other causes of your symptoms. He or she may also take a tiny sample (biopsy) of tissue from your uterus for testing.
How is it treated?
Let your doctor know if you have abnormal uterine bleeding. There are many ways to help treat it. Some are meant to return the menstrual cycle to normal. Others are used to reduce bleeding or to stop monthly periods. Each treatment works for some women but not others. Treatments include:
- Hormones, such as a progestin pill or daily birth control pill (progestin and estrogen). These hormones help control the menstrual cycle and reduce bleeding and cramping.
- Use of the levonorgestrel IUD, which releases a progesterone-like hormone into the uterus. This reduces bleeding while preventing pregnancy.
- Hysteroscopy to remove polyps or fibroids.
- Surgery, such as endometrial ablation or hysterectomy, when other treatments do not work.
If you also have menstrual pain or heavy bleeding, you can take regular doses of a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen.
In some cases, doctors use watchful waiting, or a wait-and-see approach. It may be okay for a teen or for a woman nearing menopause. Some teens have times of irregular vaginal bleeding. This usually gets better over time as hormone levels even out. Women in menopause can expect their periods to stop. They may choose to wait and see if this happens before they try other treatments.