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Abnormal uterine bleeding is a common condition that is defined as heavy menstrual flow, or unexpected or prolonged bleeding. The incidence of abnormal uterine bleeding increases as women grow older. Abnormal uterine bleeding may be caused by a variety of factors and, depending on the cause and nature of the bleeding, there are a variety of treatments available.
The most common type of abnormal uterine bleeding is dysfunctional uterine bleeding. Normal menstruation occurs when there is a drop in the progesterone level, which usually occurs about 14 days after ovulation (release of the egg from the ovary). When you do not ovulate, your ovaries do not produce progesterone, so the lining of the uterus does not shed in an orderly fashion as it normally does. Because the lining of the uterus does not undergo this orderly shedding, it becomes thicker and breaks down in a very irregular fashion. As a result, virtually any type bleeding pattern may be encountered from prolonged heavy bleeding to intermittent irregular bleeding. This is dysfunctional uterine bleeding.Other causes of abnormal uterine bleeding include endometrial polyps, fibroids, infection, malignancy, and complications of pregnancy. Other less common causes may include certain medications, thyroid problems, or disturbances in blood clotting. Polyps are small growths of the uterus and are composed of soft uterine lining tissue. Polyps usually do not cause pain, but may cause bleeding, even when small. Fibroids are benign growths of smooth muscle in the lining or wall of the uterus. Complications of pregnancy, which may cause abnormal bleeding, include threatened miscarriage or tubal (ectopic) pregnancy. In order to make certain that these potential causes of abnormal bleeding are not present, a variety of approaches are used including: taking your history, a thorough examination, a pelvic examination, and laboratory tests. The laboratory tests might include a complete blood count, thyroid test, or pregnancy test. Depending on your age and condition, an ultrasound may be needed or a biopsy of the lining of the uterus may be helpful to determine the cause of the bleeding. In other circumstances, visualization of the inside of the uterus may provide information that would be beneficial. This procedure is called hysteroscopy.
Treatments for abnormal uterine bleeding include medications, endometrial ablation, and hysterectomy.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee.
Date Published: 2004-03-11
*The recommendations and information provided by this Web site are for educational purposes only. This Web site does not contain comprehensive coverage of the topics addressed, and is not a substitute for direct consultation with your health care provider. Always consult a health care provider regarding your specific condition. Trademarks referred to are the property of their respective owners.
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