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    Your doctor must first rule out all other causes of vaginal bleeding before diagnosing abnormal uterine bleeding. These causes include miscarriage and problems with pregnancy. Vaginal bleeding may also be caused by common conditions, such as uterine fibroids.

    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.

    You have abnormal uterine bleeding if, after testing, your doctor finds no other diseases or conditions that are causing your symptoms.

    There are many things you can do to treat abnormal uterine bleeding. 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.
    • A short course of high-dose estrogen. Estrogen is a hormone that is often used to stop dangerously heavy bleeding.
    • Use of the levonorgestrel IUD, which releases a progesterone-like hormone into the uterus. This reduces bleeding while preventing pregnancy.
    • Rarely used medicines that stop estrogen production and menstruation, such as gonadotropin-releasing hormones. These drugs can cause severe side effects but are used in special cases.
    • 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.

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