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Abnormal menstrual bleeding


Causes of Abnormal menstrual bleeding

  • Problems with ovulation – The most common type of abnormal bleeding results from changes in the hormonal control of menstruation that cause problems with the release of the egg (ovulation). This type is called abnormal uterine bleeding due to ovulatory dysfunction.
  • Fibroids and polyps
  • A condition in which the endometrium grows into the wall of the uterus known as Adenomyosis.
  • Bleeding disorders
  • Problems linked to some birth control methods, such as an intrauterine device (IUD) or birth control pills
  • Miscarriage
  • Ectopic pregnancy
  • Certain types of cancer, such as cancer of the uterus, and Cancer cervix


Based on your symptoms and your age, along with symptoms and physical examination other tests may be needed.

Ultrasound exam—

Sound waves are used to make a picture of the pelvic organs.
  • Hysteroscopy— A thin, lighted scope is inserted through the vagina and the opening of the cervix. It allows your ob-gyn or other health care professional to see the inside of the uterus.
  • Endometrial biopsy— A sample of the endometrium is removed and looked at under a microscope.
  • Sonohysterography— Fluid is placed in the uterus through a thin tube while ultrasound images are made of the inside of the uterus.
  • Magnetic resonance imaging (MRI)— Rarely MRI or CT scan may be needed to make a diagnosis.

Management and Treatment-

Medical Treatment-
  • Hormonal birth control methods—Birth control pills, the skin patch, and the vaginal ring contain hormones. These hormones can lighten menstrual flow. They also help make periods more regular.
  • Tranexamic acid—This medication treats heavy menstrual bleeding.
  • Nonsteroidal anti-inflammatory drugs—These drugs, which include ibuprofen, may help control heavy bleeding and relieve menstrual cramps.

Surgical treatment-

If medication does not reduce your bleeding, a surgical procedure may be needed. There are different types of surgery depending on your condition, your age, and whether you want to have more children.

  • Endometrial ablation destroys the lining of the uterus. It stops or reduces the total amount of bleeding. Pregnancy is not likely after ablation, but it can happen. If it does, the risk of serious complications, including life-threatening bleeding, is greatly increased. If you have this procedure, you will need to use birth control until after menopause.
  • Uterine artery embolization is a procedure used to treat fibroids. This procedure blocks the blood vessels to the uterus, which in turn stops the blood flow that fibroids need to grow.
  • Myomectomy,surgical procedure in which Fibroids are removed but not the uterus.
  • Hysterectomy, the surgical removal of the uterus, is used to treat some conditions or when other treatments have failed. Hysterectomy also is used to treat endometrial cancer. After the uterus is removed, a woman can no longer get pregnant and will no longer have periods.