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
- 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
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
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.