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Abnormal Uterine Bleeding

The menstrual cycle is measured from the first day of your period through the first day of your next period. A normal menstrual cycle length is between 21-35 days with 28 days being the average for most women. A normal period length is 2-7 days. If you have a cycle or period that is shorter or longer than this, it is abnormal. It is helpful to track your periods using a calendar and note the approximate amount of blood loss (number of tampons/pads used) prior to seeing a physician.

Some examples of AUB are if you have spotting in between periods, bleeding after intercourse, a period that is heavier or longer than normal, lack of a period for several months without pregnancy, or bleeding after menopause. There are many potential causes of AUB, these include, pregnancy (normal, ectopic, miscarriage), bleeding disorders, polyps, fibroids, sexually transmitted infections (STIs), cancer (uterus, cervix, vagina), endometrial hyperplasia, iatrogenic (caused by medication/birth control), polycystic ovarian syndrome (PCOS), and many other possibilities.

When you see a physician, they will perform a physical exam including a pelvic exam with possible collection of a pap smear or biopsy of the uterine lining, etc to determine what is causing the bleeding. They may also order imaging (ultrasound, MRI, etc) or blood tests to further help them identify the cause of the bleeding. Sometimes a surgery called hysteroscopy is necessary to look inside the uterus.

There are multiple treatment options depending on what is causing the bleeding, these include, but are not limited to, NSAIDs (anti-inflammatory drugs), antibiotics, hormonal birth control, hysteroscopy, dilation and curettage (scraping the lining of the uterus), endometrial ablation (burning the lining of the uterus), or hysterectomy (surgical removal of the uterus).

If you are experiencing abnormal uterine bleeding, make an appointment with an OB/GYN to discuss treatment options.