Abnormally heavy or prolonged menstrual bleeding is also termed as ‘abnormal uterine bleeding’. We sometimes use this general term to describe bleeding that does not follow a normal pattern, such as spotting between periods. This sometimes used to be referred to as menorrhagia, but this term is no longer used medically.
Abnormally heavy or prolonged menstrual bleeding is also called abnormal uterine bleeding. We sometimes use this general term to describe bleeding that does not follow a normal pattern, such as spotting between periods. This sometimes used to be referred to as menorrhagia, but this term is no longer used medically.
On average, a typical woman passes around 40 ml of blood during her menstrual period, which lasts around four to seven days. For some women, however, bleeding may be excessively heavy or go on for longer than normal.
A woman may have ‘chronic’ heavy or prolonged bleeding (for more than six months) or it may be ‘acute’ (sudden and severe). In most cases, the causes of disturbed menstrual bleeding are unknown. See your doctor about any abnormal menstrual bleeding.
Symptoms of abnormal uterine bleeding
Symptoms include:
heavy (more than 80 ml) or prolonged (more than eight days) blood loss during the menstrual period. If you think you may be experiencing heavy menstrual bleeding, you may find it useful to keep a pictorial blood loss assessment chart
bleeding or spotting between periods (intermenstrual bleeding)
cramping and pain in the lower abdomen
fatigue.
Causes of abnormal uterine bleeding
While in many cases, it is not possible to determine the exact cause, there are a number of reasons a woman may experience abnormal uterine bleeding. Some of the known causes of abnormal uterine bleeding include:
abortion – includes either spontaneous (miscarriage) or induced
ectopic pregnancy – lodgement of the fertilised egg in the slender fallopian tube instead of the uterine lining
hormonal disorders – conditions such as hypothyroidism (low levels of thyroxine), polycystic ovarian syndrome (PCOS) and hyperprolactinemia can disrupt the menstrual cycle
ovulatory dysfunction – this is when the ovary does not release an egg each month. Most commonly, this occurs at either end of a woman’s reproductive years, either during puberty or at menopause
endometriosis – the cells lining the uterus (endometrial cells) can travel to, attach and grow elsewhere in the body, most commonly within the peritoneal cavity, (including on the outside of the uterus or on the ovarian surface
infection – including chlamydia or pelvic inflammatory disease (PID)
medications – may include anticoagulants, which hinder the clotting ability of the blood, phenothiazides, which are antipsychotic tranquilisers, and tricyclic antidepressants, which affect serotonin uptake
intrauterine device (IUD) – is a contraceptive device that acts as a foreign body inside the uterus and prompts heavier periods
hormonal contraceptives – may include the combined oral contraceptive pill, injections of a long-acting synthetic progesterone, a rod containing slow-release progesterone (implanted in the upper arm), or intrauterine system devices (progesterone-releasing contraceptive devices inserted into the uterus). The progesterone-only treatments commonly cause spotting
hormone replacement therapy – is used as a treatment for menopausal symptoms
fibroids – benign tumours that develop inside the uterus
polyps – small, stalk-like projections that grow out of the uterus lining (endometrium). Polyps may be associated with fibroids
bleeding disorders – may include leukaemia and Von Willebrand’s disease
cancer – most uterine cancers develop in the lining of the uterus, though some cancers grow in the muscle layers of the uterus. They are most common after menopause.
Research into abnormal uterine bleeding
In most cases, the cause of abnormal uterine bleeding is unknown, although research into abnormal uterine bleeding is ongoing.
Diagnosis of abnormal uterine bleeding
The diagnosis and identification of potential causes of abnormal uterine bleeding involves a number of tests including:
general examination
medical history
menstrual history
physical examination
pap test
blood tests
vaginal ultrasound
endometrial biopsy.
Treatment for abnormal uterine bleeding
Treatment will depend on the cause, but may include:
medication – such as prostaglandin inhibitors, hormone replacement therapy or antibiotics
dilatation and curettage (D&C) – involving dilation and gentle scraping of the cervix and the lining of the uterus
change of contraception – it may be necessary to explore methods of contraception other than the IUD or hormones
surgery – to remove tumours, polyps or fibroids or to treat ectopic pregnancy
treatment of underlying disorders – such as hypothyroidism or a bleeding disorder
hysterectomy – the removal of the entire uterus is a drastic last resort, generally only considered in cases where treatment for abnormal uterine bleeding, unless serious disease, such as cancer, is also present.
Self-help suggestions for managing abnormal uterine bleeding
Suggestions for managing abnormal uterine bleeding include:
Get plenty of rest.
Avoid aspirin, since this is an anticoagulant and may contribute to excessive bleeding.
Eat a well-balanced diet.
Take iron supplements to prevent anaemia.
Things to remember
Abnormal uterine bleeding is excessive menstrual bleeding or bleeding between periods.
In most cases, the cause is not known.
Known causes of abnormal uterine bleeding include polyps, fibroids, endometriosis, medications, infection and some forms of contraception.
Treatment can include medications, or dilatation and curettage (D&C) to remove the uterine lining.
Abnormally heavy or prolonged menstrual bleeding is also called abnormal uterine bleeding. We sometimes use this general term to describe bleeding that does not follow a normal pattern, such as spotting between periods. This sometimes used to be referred to as menorrhagia, but this term is no longer used medically.
On average, a typical woman passes around 40 ml of blood during her menstrual period, which lasts around four to seven days. For some women, however, bleeding may be excessively heavy or go on for longer than normal.
A woman may have ‘chronic’ heavy or prolonged bleeding (for more than six months) or it may be ‘acute’ (sudden and severe). In most cases, the causes of disturbed menstrual bleeding are unknown. See your doctor about any abnormal menstrual bleeding.
Symptoms of abnormal uterine bleeding
Symptoms include:
heavy (more than 80 ml) or prolonged (more than eight days) blood loss during the menstrual period. If you think you may be experiencing heavy menstrual bleeding, you may find it useful to keep a pictorial blood loss assessment chart
bleeding or spotting between periods (intermenstrual bleeding)
cramping and pain in the lower abdomen
fatigue.
Causes of abnormal uterine bleeding
While in many cases, it is not possible to determine the exact cause, there are a number of reasons a woman may experience abnormal uterine bleeding. Some of the known causes of abnormal uterine bleeding include:
abortion – includes either spontaneous (miscarriage) or induced
ectopic pregnancy – lodgement of the fertilised egg in the slender fallopian tube instead of the uterine lining
hormonal disorders – conditions such as hypothyroidism (low levels of thyroxine), polycystic ovarian syndrome (PCOS) and hyperprolactinemia can disrupt the menstrual cycle
ovulatory dysfunction – this is when the ovary does not release an egg each month. Most commonly, this occurs at either end of a woman’s reproductive years, either during puberty or at menopause
endometriosis – the cells lining the uterus (endometrial cells) can travel to, attach and grow elsewhere in the body, most commonly within the peritoneal cavity, (including on the outside of the uterus or on the ovarian surface
infection – including chlamydia or pelvic inflammatory disease (PID)
medications – may include anticoagulants, which hinder the clotting ability of the blood, phenothiazides, which are antipsychotic tranquilisers, and tricyclic antidepressants, which affect serotonin uptake
intrauterine device (IUD) – is a contraceptive device that acts as a foreign body inside the uterus and prompts heavier periods
hormonal contraceptives – may include the combined oral contraceptive pill, injections of a long-acting synthetic progesterone, a rod containing slow-release progesterone (implanted in the upper arm), or intrauterine system devices (progesterone-releasing contraceptive devices inserted into the uterus). The progesterone-only treatments commonly cause spotting
hormone replacement therapy – is used as a treatment for menopausal symptoms
fibroids – benign tumours that develop inside the uterus
polyps – small, stalk-like projections that grow out of the uterus lining (endometrium). Polyps may be associated with fibroids
bleeding disorders – may include leukaemia and Von Willebrand’s disease
cancer – most uterine cancers develop in the lining of the uterus, though some cancers grow in the muscle layers of the uterus. They are most common after menopause.
Research into abnormal uterine bleeding
In most cases, the cause of abnormal uterine bleeding is unknown, although research into abnormal uterine bleeding is ongoing.
Diagnosis of abnormal uterine bleeding
The diagnosis and identification of potential causes of abnormal uterine bleeding involves a number of tests including:
general examination
medical history
menstrual history
physical examination
pap test
blood tests
vaginal ultrasound
endometrial biopsy.
Treatment for abnormal uterine bleeding
Treatment will depend on the cause, but may include:
medication – such as prostaglandin inhibitors, hormone replacement therapy or antibiotics
dilatation and curettage (D&C) – involving dilation and gentle scraping of the cervix and the lining of the uterus
change of contraception – it may be necessary to explore methods of contraception other than the IUD or hormones
surgery – to remove tumours, polyps or fibroids or to treat ectopic pregnancy
treatment of underlying disorders – such as hypothyroidism or a bleeding disorder
hysterectomy – the removal of the entire uterus is a drastic last resort, generally only considered in cases where treatment for abnormal uterine bleeding, unless serious disease, such as cancer, is also present.
Self-help suggestions for managing abnormal uterine bleeding
Suggestions for managing abnormal uterine bleeding include:
Get plenty of rest.
Avoid aspirin, since this is an anticoagulant and may contribute to excessive bleeding.
Eat a well-balanced diet.
Take iron supplements to prevent anaemia.
Things to remember
Abnormal uterine bleeding is excessive menstrual bleeding or bleeding between periods.
In most cases, the cause is not known.
Known causes of abnormal uterine bleeding include polyps, fibroids, endometriosis, medications, infection and some forms of contraception.
Treatment can include medications, or dilatation and curettage (D&C) to remove the uterine lining.
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