What is Abnormal Vaginal Bleeding

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Abnormal bleeding is defined as bleeding between monthly cycles, prolonged bleeding, or a heavy flow of bleeding. Abnormal bleeding is also known as menometrorrhagia. A menstrual cycle will normally only last for 5-7 days and occur every 21-35 days. When you experience any abnormal bleeding, it is advised that you speak to your doctor. It can be a sign of an underlying medical condition that needs to be looked at. 

The term ‘abnormal uterine bleeding’ mainly describes the bleeding of women who are not pregnant. Abnormal bleeding during pregnancy and menopause can still be seen as a red flag and you should consult your doctor. Bleeding after menopause is never normal and might be an indication of cancer and for women who are pregnant, it might require medical attention.


What is Menometrorrhagia?

Menometrorrhagia is the umbrella term for menorrhagia (prolonged/excessive menstruation) and metrorrhagia (bleeding not related to menstruation). In 2011 the terms changed to prevent confusion. Menorrhagia is now called ‘heavy menstrual bleeding’ and menometrorrhagia is now called ‘uterine bleeding’. Most of the time, hormonal imbalances are to reason for abnormal uterine bleeding. It is commonly seen in women just starting or ending their period cycles. 


Sings and Symptoms

Signs of abnormal bleeding can differ from woman to woman since everyone’s body functions differently. Some signs of abnormal bleeding are heavy menstrual bleeding, bleeding at unusual times, prolonged periods, and inconsistent cycles. 


What Causes Abnormal Bleeding?

Abnormal bleeding can have a few causes which might be related to stress or underlying medical conditions. 

Being overweight can increase your chances of hormonal imbalance which can lead to abnormal bleeding. Other conditions related to hormonal imbalance are ovulation, thyroid disease and polycystic ovarian syndrome also known as PCOS. Structural abnormalities in your uterus such as abnormal growth can also cause abnormal bleeding. Polyps, fibroids, and adenomyosis are examples of structural abnormalities. A polyp is a growth of tissue, they are normally seen growing on the endometrium (inner lining of the uterus). Fibroids are muscular growths, growing on the myometrium. Adenomyosis is when the endometrial tissue grows into the myometrium. 

Abnormal bleeding can also be caused by cancer such as uterine cancer, cervical cancer, vaginal cancer, ovarian cancer, and endometrial hyperplasia. Infections such as trichomoniasis, cervicitis, chlamydia, gonorrhoea, and vaginitis can also cause abnormal bleeding. A medical condition such as endometriosis can also cause abnormal uterine bleeding. Endometriosis is when tissue that is similar to the inner lining of the uterus (endometrium) grows on the outside of the uterus. Medications containing hormones such as tamoxifen (used for breast cancer), intrauterine devices and contraceptive medication can also cause abnormal uterine bleeding. 


Abnormal Bleeding During Teens, 20s, and 30s

Pregnancy is a common cause of abnormal bleeding during the teenage years. During the first few months of pregnancy, abnormal bleeding can occur. Some contraceptive pills and intrauterine devices (IUDs) can also cause abnormal bleeding. Abnormal bleeding can also occur during ovulation, this is known as spotting. 


Abnormal Bleeding During Tour 40s and 50s

Women don’t usually ovulate when menopause begins due to a hormonal imbalance of oestrogen and progesterone. During menopause, you should not be bleeding. It is important that you schedule an appointment with your doctor when you experience bleeding in this age group. 


Different Tests to Diagnose Abnormal Bleeding

Your healthcare provider will ask you a few questions to get a better understanding of what might cause your abnormal uterine bleeding. Your doctor will also perform a physical exam, which includes a pelvic exam, a cervical exam, and a pap smear. A pap smear is when your doctor uses a thin plastic instrument to collect tissue cells from your cervix. Your healthcare provider might also want to order several tests to help with your diagnosis. These tests include a pregnancy test, blood tests, thyroid tests, hormone level test, a hysteroscopic exam, pelvic ultrasound, and a biopsy of your endometrium


 When Should I See a Healthcare Provider?

It is recommended that you make an appointment with your doctor if you notice unusual abnormal uterine bleeding.  If bleeding decreases your quality of life then it is advised to make a doctor’s appointment. 

Symptoms to look out for:

  • Blood clots that are bigger than a quarter
  • Changing menstrual products (sanitary pads and tampons) every 2 hours
  • Bleeding between periods that last longer than a week
  • Feeling fatigued, weak, and short of breath
  • Hair loss and pallor (pale skin)


Can Abnormal Uterine Bleeding be Prevented?

Abnormal bleeding can not be prevented. It is your body’s way of telling you that something is wrong. Maintaining a healthy weight can prevent some cases of abnormal bleeding since your weight affects your hormonal production. 

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