Abnormal Uterine Bleeding: What You Need to Know
Abnormal uterine bleeding (AUB) is any bleeding that鈥檚 excessive, bothersome or outside what a woman would consider normal during menstruation, or any bleeding between periods. That鈥檚 the concise definition provided by Dr. Denise Howard, Chief of Obstetrics and Gynecology at NewYork-Presbyterian Brooklyn Methodist Hospital and Associate Professor of Clinical Obstetrics and Gynecology at 麻豆传媒高清版.听
AUB accounts for 18 to 30 percent of gynecological visits, Dr. Howard says. However, heavy menstrual bleeding may affect about 50 percent of women during their reproductive years.听
Read on for her answers to your FAQs and her advice regarding when to seek care for this common yet troublesome condition.听
What is meant by the term 鈥渁bnormal鈥?听
A patient may have menstrual bleeding that becomes excessive. She may also have spotting between periods, which could be a sign of one or more of the following:听
- Fibroids听
- Polyps听
- Hormonal issues听
- Uterine or cervical cancer听
鈥If you have heavy periods that interfere with your quality of life,鈥 she says, 鈥測ou don鈥檛 need to suffer. The term 鈥abnormal鈥 can mean what鈥檚 abnormal for you. Be aware that there are numerous ways to control abnormal uterine bleeding, so don鈥檛 hesitate to make an appointment with your gynecologist to explore these.鈥听
Who is at risk for AUB?听
Any girl or woman of reproductive age is at risk for the condition.听
Are menopausal women also at risk?听
Women approaching menopause may experience heavy, irregular periods. If you go 12 months without a period, 测辞耻鈥檙别 officially 鈥渋n鈥 menopause, Dr. Howard explains.听听
鈥淚f 测辞耻鈥檙别 menopausal and you experience any bleeding, see your gynecologist immediately. Post-menopausal bleeding may be a sign of cancer, so make sure to be evaluated as soon as possible.鈥听
How do you evaluate a patient who comes to you for help with her AUB?听
鈥淲e begin with a thorough medical history which also includes menstrual, pregnancy,听 gynecologic, family and surgical history,鈥 she says, 鈥渇ollowed by indicated tests such as blood work to see whether 测辞耻鈥檙别 anemic; hormonal abnormalities, such as thyroid issues or abnormal prolactin levels; and/or imaging to visualize the uterus and ovaries. We note any family history of reproductive cancer. Depending on our findings, we may order a biopsy to confirm or rule out cancer.鈥听
What methods are available for managing the condition?听
A wide range of methods are available, she says, explaining that the approach to treatment will depend on the patient鈥檚 age, risk factors, quality of life concerns and desire for future fertility.听
Sometimes, she says, there can be a very simple solution to abnormal uterine bleeding. 鈥淚f 测辞耻鈥檙别 a 25-year-old who is sexually active, a hormonal contraceptive can resolve the problem. And even if 测辞耻鈥檙别 young and not sexually active, that can be an effective option.听听
鈥淚f 测辞耻鈥檙别 a competitive athlete, it may be inconvenient for you to have a period during a competitive event,鈥 she continues. 鈥Or if 测辞耻鈥檙别 traveling, you might prefer to avoid having one. A hormonal contraceptive can deliver lighter periods or even no period at all,鈥 and that allows a woman to plan and predict her menses.听
Hormonal contraceptives come in several forms: an oral formula (the birth control pill), a patch, a vaginal ring or a hormonal IUD.听
Additionally, Dr. Howard points to surgery, should that be needed to remove polyps or fibroids鈥攏on-cancerous tumors in the uterus. In the case of uterine cancer, a hysterectomy made need to be performed鈥攂ut for women who want to retain their fertility, that option is only used in a worst-case context.听听
When should I see a gynecologist?听
鈥淓very woman over age 21 should be screened for cervical cancer, and any girl or woman who is sexually active, has menstrual problems or wants to be checked should have a regular gynecological exam,鈥 she says.听听
鈥淎bnormal bleeding can range from annoying, inconvenient or bothersome all the way to medically significant. Whatever its cause, and whatever your level of concern, discussing the issue with your gynecologist will open the door to a conversation about its impact on your quality of life.听听
鈥淵ou don鈥檛 need to 蝉耻蹿蹿别谤,鈥 Dr. Howard reiterates. 鈥淭ogether, we can find the right option to manage your abnormal bleeding.鈥听
Make an appointment with a gynecologist at 麻豆传媒高清版 .听