Overview 

Abnormal uterine bleeding is bleeding that lasts longer than normal or occurs spontaneously at irregular intervals. The bleeding can be heavy or light and occur persistently or develop spontaneously.

Signs

• Irregular bleeding between periods
• Bleeding over several days (menorrhagia)
• Vaginal bleeding after sexual intercourse
• Bleeding at an early age (age 9)
• Vaginal bleeding that occurs after menopause
• Longer or shorter menstrual cycles (over 35 days or under 21 days)

Causes

Abnormal uterine bleeding may occur for several reasons due to certain medical conditions or even stress. For example, heavy bleeding between periods may occur due to hormone imbalances as a result of anovulation, thyroid problems and polycystic ovarian syndrome (PCOS). Furthermore, abnormal vaginal bleeding may arise due to structural issues affecting the uterus, such as uterine polyps, fibroids and adenomyosis.

In some cases, spontaneous and heavy vaginal bleeding may signify precancerous and cancerous conditions like endometrial hyperplasia, uterine cancer, ovarian cancer, cervical cancer and vaginal cancer.

Treatment

It's important to determine the cause of heavy vaginal bleeding to rule out more serious health conditions. Treatment depends on the cause of vaginal bleeding. However, treatment modalities include medications and surgery to ease or regulate the bleeding.

Typical treatments include the following:

• Progestin pills are prescribed to ease heavy vaginal bleeding by thinning the uterus lining.

Despite medications available to relieve pain and symptoms, surgical procedures are carried out to address this health concern, such as:

• Hysteroscopy is a procedure carried out to remove uterine polyps and fibroids
• Uterine artery embolisationaims to shrink fibroids by severing their blood supply.
• Myomectomy is a procedure to remove fibroids while, at the same time, preserving the uterus.
• Ablation uses heat to attack the uterine lining to prevent irregular bleeding.
• Hysterectomy is the surgical resection of the uterus to resolve cancer or changes in the endometrium, signalling cancer.

FAQ