Abnormal Uterine Bleeding
Our women’s health team provides compassionate care and advanced treatment options tailored to you, helping you find answers and relief from abnormal bleeding.
Understanding the shifts in your cycle
For many people, a menstrual cycle is something they’ve counted on for years, with the same rhythm and the same rough timeline, month after month. So when something shifts, it’s hard not to notice. Heavier bleeding, irregular timing, or spotting between periods are worrisome and deserve attention.
Abnormal uterine bleeding is a common reason people seek care from an OB/GYN, and the women’s health team at Reid Health in East Central Indiana and West Central Ohio is here to help you sort it out.
What is abnormal uterine bleeding?
Abnormal uterine bleeding is any bleeding from the uterus that doesn’t fit your normal pattern. It includes bleeding you might feel is too heavy, too light, too frequent, or irregular. It also includes bleeding between periods or after menopause.
Normal menstrual cycles vary from person to person, but most last between 21 and 35 days, with bleeding lasting four to seven days. If your bleeding falls outside of what’s typical for you, it might be worth talking to a provider.
What does abnormal uterine bleeding look like?
Abnormal uterine bleeding isn’t just about your cycle. It can also affect your energy levels by causing anemia. See your provider if you often feel very tired, weak, or short of breath. Other symptoms of abnormal uterine bleeding include:
- Cycles shorter than 21 days or longer than 35 days
- Bleeding after menopause
- Bleeding after sex
- Bleeding or spotting between periods
- Periods lasting longer than seven days
- Periods much heavier or lighter than usual
- Soaking through a pad or tampon every hour for several hours in a row during your period
What is the most common cause of abnormal uterine bleeding?
Ovulation problems occur when the body fails to release an egg each month, triggering irregular bleeding.
Other possible causes of abnormal uterine bleeding include:
- Bleeding disorders: These conditions alter the way your blood clots, which can lead to prolonged or heavy periods.
- Certain medications: Some prescription drugs, including blood thinners and hormonal therapies, can disrupt your normal cycle.
- Endometrial cancer: This is a type of cancer that affects the lining of the uterus.
- Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovarian syndrome or PCOS: This complex hormonal imbalance frequently disrupts ovulation and creates irregular cycles.
- Pregnancy complications: Sudden abnormal bleeding can signal an underlying issue such as a miscarriage or an ectopic pregnancy.
- Thyroid disorders: An overactive or underactive thyroid gland can cause an irregular menstrual cycle.
- Uterine fibroids: These noncancerous muscular growths develop in or around the uterine wall and often cause heavy bleeding and cramping.
- Uterine polyps: These cancerous or precancerous growths attach to the inner lining of the uterus and frequently cause spotting between periods.
When to see a provider for abnormal uterine bleeding
It can be hard to know when a change in your cycle is worth a call to your provider and when it’s just one of those months, but if something feels off, it’s always reasonable to have it checked. Although most abnormal uterine bleeding isn’t life-threatening and rarely requires an emergency visit, it isn’t something you should put off — especially if you’re experiencing heavy or persistent bleeding or bleeding after menopause.
You should seek immediate care in the emergency department if you’re soaking through more than one pad an hour for more than two hours in a row, experiencing chest pain or shortness of breath, or feeling dizzy or faint.
Can abnormal uterine bleeding stop on its own?
For teenagers and younger individuals, irregular cycles often even out naturally over time as hormone levels stabilize. Similarly, if your bleeding stems from temporary factors like high stress or lifestyle changes, your cycle might return to its normal rhythm on its own.
However, you should always have an OB/GYN evaluate unexpected changes first to rule out serious conditions. Once your provider confirms there are no dangerous underlying issues, watchful waiting can be a safe approach. Keep in mind that bleeding caused by structural problems like fibroids or polyps typically will not stop on its own and will require medical management.
What will a provider do for abnormal uterine bleeding?
The approach depends on what’s causing the bleeding, so your provider will likely start with some questions and tests before diagnosing and recommending treatment.
Diagnosis
Your provider will start by asking about your symptoms, medical history, and menstrual cycle. They might also ask how long the bleeding has been happening and how it affects your day-to-day life. From there, they might recommend one or more of the following:
- Blood tests, such as a complete blood count, to check for anemia or thyroid problems
- An endometrial biopsy to sample the lining of the uterus
- A hysteroscopy, which lets your provider look inside the uterus with a small camera
- A pelvic ultrasound to look at the uterus and ovaries
Treatment
Treatment depends on what’s causing the bleeding, your age, your overall health, and whether you’d like to get pregnant in the future. Common options include:
- Hormonal therapy: Birth control pills or a hormonal intrauterine device (IUD) can regulate bleeding.
- Medications: Your provider might recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or tranexamic acid to reduce heavy bleeding.
- Minimally invasive procedures: Options like endometrial ablation can treat abnormal bleeding by safely destroying the inner lining of the uterus.
- Gynecologic surgery: In some cases, providers might recommend surgery to remove the uterus (hysterectomy), fibroids, or polyps.
Your provider will walk you through the options and help you determine the best customized plan for your needs. Many causes of abnormal uterine bleeding are treatable, and many can be managed without major surgery.
Care for all ages and stages
Abnormal uterine bleeding is common but figuring out what’s causing it — and what to do about it — is a lot easier with the right team in your corner. Whether you’re in your 20s, approaching menopause, or somewhere in between, Reid’s women’s health providers will take the time to understand your health concern and work with you on next steps.