Abnormal Uterine Bleeding

Overview

Abnormal uterine or vaginal bleeding is common and has many causes. It can affect daily life and lead to anaemia. Bleeding after menopause always needs to be checked by a doctor.

Symptoms

• Periods that are very heavy, last longer than seven days or come more often than every 21 days
• Bleeding or spotting between periods or after sex
• Passing large clots
• Tiredness or breathlessness from anaemia
• Any bleeding after menopause

Causes and risk factors

Causes include hormonal imbalance, polycystic ovary syndrome, fibroids, polyps, adenomyosis, thyroid problems, bleeding disorders, contraceptives, pregnancy complications and, less often, cancer of the uterus or cervix.

Diagnosis

Your doctor will take a history and do a pelvic examination. Tests may include a pregnancy test, blood tests, a pelvic ultrasound, a Pap smear, and sometimes a biopsy of the womb lining or hysteroscopy.

Treatment

Treatment depends on the cause and may include iron, hormonal medicines, non-hormonal medicines to reduce bleeding, a hormonal coil, or procedures to remove fibroids or polyps.

When to see a doctor

See a gynaecologist for any change in your usual bleeding pattern or bleeding after menopause. Seek urgent care for very heavy bleeding, fainting, or bleeding during pregnancy.