Abnormal Uterine Bleeding

If your period lasts seven or more days you may have a condition called menorrhagia or abnormal uterine bleeding

With abnormal uterine bleeding your monthly flow may be so excessive that you need to change protection nearly every hour. Women suffering from menorrhagia can experience fatigue, anemia, embarrassing accidents, and restricted activity. If you’re familiar with these effects, you know that menorrhagia can disrupt your life. And you are not alone. About 1 in 5 women experience unusually heavy menstrual bleeding. And there are now more treatment options available to you.

During the menstrual cycle, two hormones, called estrogen and progesterone, are made by the ovaries. Each month, these hormones cause the endometrium to grow in preparation for a possible pregnancy. About 12–14 days before the start of the period, an egg is released from one of the ovaries. This is called ovulation. The egg then moves into one of the fallopian tubes. There it can be fertilized by a sperm. If it is not, pregnancy does not occur. The levels of hormones decrease. This decrease is a signal for the uterus to shed its lining. This shedding is the menstrual period.

Menstruation is considered normal when uterine bleeding occurs every 21 to 35 days and is not excessive.

The normal duration of menstrual bleeding is between two and seven days. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine bleeding differs from that mentioned above or the woman has spotting in between her menstrual periods.

Bleeding in any of the following situations is abnormal.

  • Bleeding between periods
  • Bleeding after sex
  • Spotting anytime in the menstrual cycle
  • Bleeding heavier or for more days than normal
  • Bleeding after menopause

Abnormal uterine bleeding is caused by a variety of factors.

The two main causes are structural abnormalities of the reproductive system and ovulation disorders. Some of the more common structural causes of abnormal uterine bleeding include benign (non-cancerous) lesions of the uterus, such as polyps, fibroids, and adenomyosis.

Other causes include bleeding associated with early pregnancy, including miscarriage and ectopic pregnancy, and bleeding disorders which affect the ability of the blood to clot normally. Lesions of the cervix or vagina (benign and cancerous), chronic infections of the endometrial lining, scar tissue in the endometrium, and the use of an intrauterine device (IUD).

Additional causes of abnormal bleeding include medications which can affect the normal release of estrogen and progesterone, chronic medical problems such as diabetes mellitus or other medical problems which can affect the production and metabolism of estrogen and progesterone. Emotional or physical stress as well as significant changes in body weight may disrupt the pituitary’s release of FSH and LH and prevent ovulation.