Sometimes referred to as abnormal vaginal bleeding, abnormal uterine bleeding is considered to be bleeding that occurs outside of the typical pattern of a normal menstrual cycle, which typically occurs about every 28 days and lasts for about five to seven days. It can include very heavy or very light periods, spotting between periods, bleeding after intercourse, or an absence of periods not caused by menopause.
Abnormal uterine bleeding can have several causes. Often, abnormal bleeding occurs as a result of hormonal fluctuations during perimenopause, the months and years preceding menopause, or the cessation of periods. Other times, abnormal bleeding may occur as a result of endometriosis, uterine fibroids, PCOS, miscarriage, pregnancy, thyroid disease, significant fluctuations in weight, prolonged strenuous physical activity, chronic stress, changes in birth control pills and breastfeeding.
Diagnosis begins with a discussion of your symptoms and a complete personal and family medical history, followed by a pelvic exam and Pap test as well as a general assessment of your overall health. In some cases, a special instrument called a colposcope may be used to look more closely at your cervix and vagina, or a hysteroscopy may be performed to look inside our uterus. An ultrasound may also be prescribed, and blood work may be ordered to look for hormonal fluctuations and other issues.
Depending on the cause, abnormal bleeding may be treated with medications to balance hormones including birth control pills and bioidentical hormones, treatment of underlying conditions such as thyroid disease, or minimally invasive procedures to remove fibroids, remove the lining of the uterus, manage endometriosis or treat other conditions. Your treatment will be customized for your specific needs.
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