Abnormal Uterine Bleeding: Causes, symptoms and treatment guide

Abnormal uterine bleeding can signal polyps, fibroids, hormonal imbalance or ovulatory issues. Know symptoms, diagnosis, and effective treatment options. (Image: Pexels)

Abnormal Uterine Bleeding (AUB) is a common gynaecological concern, but one that often goes ignored until it disrupts daily life. It refers to any change in your menstrual volume, duration, or frequency, including heavier-than-usual flow, spotting between periods, prolonged cycles, or periods that arrive unpredictably. While occasional irregularities may be harmless, persistent changes usually signal an underlying condition that needs medical evaluation.

What Causes Abnormal Uterine Bleeding?

AUB can occur due to a number of reasons, like structural issues in the uterus, hormonal imbalances, or systemic medical conditions. and must be evaluated with a thorough menstrual history and pelvic examination, along with an ultrasound.

Here’s a breakdown of the most common causes:

1. AUB Due to Polyps

Polyps in the endometrium or the cervix may cause inter-menstrual bleeding. Symptoms like irregular bleeding, pelvic discomfort and infertility may be noticed by the affected persons. A transvaginal ultrasound can aid in diagnosing this condition, and polypectomy may be recommended by the gynaecologist. Regular screening can aid in detecting this condition in the early stages.

Also Read: Senior doctor shares why you should never ignore these types of period pain

2. AUB Due to Adenomyosis

Adenomyosis is a condition where the endometrial (endometrium is the innermost layer of the uterus) tissue is found in the myometrium (middle layer of the uterus), which leads to heavy and painful menstruation. The uterus becomes large in size, and also becomes tender. Chronic pelvic pain is common, and medications may be given to relieve the symptoms. The definitive treatment is usually the removal of the uterus (hysterectomy).

3. AUB Due to Ovulatory Dysfunction

Conditions like polycystic ovarian disease (PCOD), thyroid disorders and stress may lead to irregular and unpredictable bleeding. This may be accompanied by the presence of acne and variable flow. Hormonal tests and pelvic imagining techniques can aid in diagnosis. Lifestyle changes and medications are often recommended, and metabolic disorders, if any, must be managed.

4. AUB Due to Fibroids

Fibroids have been found to cause heavy and prolonged bleeding as they affect the uterine contractility. The affected persons feel pressure in the lower abdomen and may show symptoms and signs of anaemia, like pallor and breathlessness on exertion. Pelvic pain is also common. Hormonal therapy and a myomectomy may be advised in some cases. Early evaluation and treatment can aid in reducing the complications.

How is AUB Diagnosed?

A proper evaluation includes:

• Detailed menstrual and medical history
• Pelvic examination
• Ultrasound to assess structural abnormalities
• Hormonal tests, if required

Treatment Options

Management depends on the cause and severity:

Medical therapy: NSAIDs for pain, tranexamic acid for heavy bleeding, and hormonal treatments

Surgical options: Myomectomy, polypectomy, or hysterectomy when indicated

Regular follow-ups: Essential to monitor treatment response and prevent complications

Also Read: Adenomyosis in women over 40: Symptoms, diagnosis and treatment options

Why Early Evaluation Matters

AUB is treatable—but ignoring symptoms can lead to prolonged discomfort, severe anaemia, or fertility issues. Seeking timely medical advice ensures safe and effective management.

FAQs on Abnormal Uterine Bleeding

1. What is abnormal uterine bleeding (AUB)?

Abnormal uterine bleeding is any change in menstrual volume, duration, or frequency, including heavier-than-usual flow, spotting between periods, prolonged cycles, or unpredictable periods.

2. What causes AUB?

AUB can be caused by structural issues in the uterus, hormonal imbalances, or systemic medical conditions.

3. How is AUB diagnosed?

Diagnosis involves a detailed menstrual and medical history, pelvic examination, ultrasound, and possibly hormonal tests.

4. What are the treatment options for AUB?

Treatment options include medical therapy, such as NSAIDs for pain and hormonal treatments, and surgical options like myomectomy, polypectomy, or hysterectomy.

5. Why is early evaluation important?

Early evaluation helps in timely management, preventing prolonged discomfort, severe anaemia, and fertility issues.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.