Understanding Abnormal Menstrual Bleeding: Causes, Diagnosis, and Treatment

Women typically experience menstrual cycles from ages 11-12 until around 50. Over these 40 years, it’s common to encounter occasional abnormal bleeding outside the regular cycle. If this persists, consulting a gynecologist is essential. Abnormal bleeding might involve prolonged, heavy bleeding with clots, irregular patterns, or associated pain.

What Constitutes a Normal Menstrual Cycle?

A typical menstrual cycle occurs every 28-35 days, lasts 7-8 days, and is usually pain-free without clots. During this cycle, hormones estrogen and progesterone stimulate the uterine lining (endometrium) to grow, which then sheds as menstrual bleeding.

The cycle starts on the first day of bleeding of one period (Day 1) and ends on the first day of the next period. An average cycle lasts about 28 days but can vary. Cycles longer than 35 days or shorter than 21 days are considered abnormal. Abnormal uterine bleeding can.

include:

• Bleeding between periods
• Bleeding after sex
• Spotting at any time
• Heavy or prolonged bleeding
• Missing periods for three cycles or six months

When Does Abnormal Bleeding Occur?

Abnormal bleeding can happen at any age but is common during certain life stages. Periods may be irregular in the first few years after menstruation begins (ages 9 to 16). As women approach menopause (around 50), cycles may shorten, and bleeding may become lighter or more sporadic. However, if bleeding becomes heavier, it should be checked by a healthcare professional.

Causes of Abnormal Bleeding

There are many causes of abnormal bleeding, ranging from minor to serious. Some causes include:

• Hormonal imbalances
• Birth control methods (IUDs, oral contraceptives)
• Pregnancy-related issues
• Uterine tumors or cancer

Diagnosing Abnormal Bleeding

To determine the cause, a gynecologist will take a detailed medical history and conduct a physical exam. Additional tests may include blood work and an ultrasound to examine the uterus. Keeping a menstrual calendar for 4-6 months can provide valuable insights. Thyroid function tests are also important, as thyroid hormone abnormalities can cause bleeding issues. In some cases, procedures like hysteroscopy or laparoscopy might be needed.

Treatment Options

Treatment for abnormal bleeding depends on the underlying cause, the patient’s age, the severity of bleeding, and future pregnancy plans. Options include:

• Medications: Non-hormonal medications can reduce pain and bleeding. Hormonal treatments may be needed to address imbalances.
• Surgery: For some women, surgical removal of growths (like fibroids or polyps) causing the bleeding might be necessary. This can often be done via hysteroscopy. Endometrial ablation, which uses heat to destroy the uterine lining, can reduce or stop bleeding but may affect fertility. Hysterectomy (removal of the uterus) is a more definitive option, usually considered when other treatments fail.

Final Thoughts

If you notice irregular menstrual cycles or abnormal bleeding, it’s crucial to consult a gynecologist. Understanding the cause of abnormal bleeding is key to effective treatment. With proper diagnosis and care, abnormal bleeding can often be managed successfully.