Abnormal uterine bleeding

Abnormal uterine bleeding (AUB), also known as menorrhagia, is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration, and volume of blood flow. AUB is a common gynecological complaint and can significantly impact a woman's quality of life, work productivity, and overall health status.

Causes

Abnormal uterine bleeding can be caused by a variety of conditions. These include, but are not limited to:

• Hormonal imbalance: This is the most common cause of AUB. Hormonal imbalances can occur due to various reasons such as polycystic ovary syndrome (PCOS), thyroid disorders, and perimenopause.
• Uterine fibroids: These are non-cancerous growths in the uterus that can cause heavy or prolonged periods.
• Endometrial polyps: These are small, benign growths on the lining of the uterus (the endometrium) that can cause irregular or heavy bleeding.
• Adenomyosis: This condition occurs when the endometrial tissue grows into the muscular wall of the uterus, causing painful and heavy periods.
• Cancer: Uterine, cervical, and ovarian cancers can all cause abnormal bleeding.

Symptoms

The primary symptom of AUB is bleeding that is irregular in frequency, duration, or volume. This can include:

• Menstrual cycles that are shorter than 24 days or longer than 38 days
• Bleeding between periods
• Heavy bleeding during periods
• Menstrual periods that last longer than a week
• Postmenopausal bleeding

Diagnosis

Diagnosis of AUB involves a thorough medical history, physical examination, and various diagnostic tests. These may include:

• Pelvic ultrasound: This imaging test can help identify abnormalities in the uterus, such as fibroids or polyps.
• Endometrial biopsy: In this procedure, a small sample of the endometrial tissue is removed and examined under a microscope.
• Hysteroscopy: This procedure involves inserting a thin, lighted tube into the vagina to examine the cervix and inside of the uterus.

Treatment

Treatment for AUB depends on the underlying cause, the severity of symptoms, and the woman's reproductive plans. Options may include:

• Hormonal therapy: This can help regulate the menstrual cycle and reduce bleeding.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These can help reduce menstrual blood loss and relieve pain.
• Surgery: In some cases, surgical removal of fibroids, polyps, or the uterus may be necessary.

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