Causes and Treatment for Abnormal Uterine Bleeding
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November, 2023

AUB (Abnormal Uterine Bleeding)

Abnormal Uterine Bleeding (AUB) is a common gynecological issue that affects many women across different age groups. Defined as any deviation from the normal menstrual cycle, AUB can have various causes and present with diverse symptoms.

Understanding Abnormal Uterine Bleeding

AUB is characterized by irregularities in the menstrual cycle, which may manifest as heavy or prolonged bleeding, irregular cycles, delayed menstrual cycles, reduced amount of bleeding/ no menses, or spotting between periods. To comprehend AUB, it's crucial to grasp the normal menstrual cycle. The menstrual cycle involves a complex interplay of hormones that regulate the growth and shedding of the uterine lining.

Causes of Abnormal Uterine Bleeding

Here are some cause of abnormal uterine bleeding:
  • Hormonal Imbalances: Hormonal fluctuations, often due to conditions like polycystic ovary syndrome (PCOS) or thyroid disorders, can disrupt the normal menstrual cycle, leading to AUB.
  • Structural Abnormalities: Anatomical issues, such as fibroids, polyps, or adenomyosis, can interfere with the uterus's ability to contract and shed its lining properly, causing abnormal bleeding.
  • Blood Clotting Disorders: Conditions that affect blood clotting, like von Willebrand disease, can result in heavy menstrual bleeding and contribute to AUB.
  • Medical Conditions: Certain illnesses, such as liver or kidney disease, can impact the body's hormonal balance and contribute to abnormal bleeding.
  • Infections or Inflammation: Infections of the reproductive organs or chronic inflammation may cause AUB.
  • Medications: Some medications, including certain types of contraceptives or anticoagulants, can affect menstrual bleeding patterns.

Recognizing Symptoms of AUB

  • Heavy Menstrual Bleeding: Experiencing excessively heavy menstrual flow that requires frequent changing of pads or tampons is a common symptom of AUB.
  • Frequent Menstruation: Menstrual cycle of less than 24 days
  • Infrequent Menstruation: Menstrual cycle of more than 38 days
  • Irregular Menstrual Cycles: AUB may manifest as irregular periods, with variations in the duration of the menstrual cycle and the amount of blood flow.
  • Prolonged Menstrual Bleeding: Menstrual periods lasting longer than seven days can indicate AUB, especially if this is a deviation from one's usual pattern.
  • Bleeding Between Periods: Spotting or bleeding between menstrual cycles is another potential sign of AUB and should be investigated by a healthcare professional.
  • Menstrual Cramps: While mild cramping is normal during menstruation, severe or prolonged menstrual cramps can be indicative of AUB.

Seeking Diagnosis and Treatment

If you suspect AUB, it is essential to consult with a healthcare provider. Diagnosis typically involves a detailed medical history, physical examination, and sometimes imaging studies like ultrasounds. Abnormal uterine bleeding treatment options depend on the underlying cause and may include:
  • Hormonal Therapy: Balancing hormones through contraceptives hormone replacement therapy or an Intrauterine system can regulate menstrual cycles.
  • Non-Hormonal Medications: Medications like tranexamic acid may be prescribed to reduce heavy bleeding.
  • Surgical Interventions: In cases of structural abnormalities, surgical procedures like hysteroscopy or endometrial ablation Removal of Fibroids (Myomectomy), Polyps(Polypectomy), and Uterus(Hysterectomy) may be recommended.
  • Lifestyle Changes: Adopting a healthy lifestyle, including exercise, a balanced diet, and stress management, and maintaining a normal weight can contribute to menstrual regularity.


Abnormal Uterine Bleeding (AUB) is a multifaceted condition with diverse causes and symptoms. If you suspect you may be experiencing AUB, it's crucial to consult with a healthcare professional at Sakra World Hospital for a proper diagnosis and personalized treatment plan. Early intervention can help manage symptoms effectively and improve overall reproductive health. Remember, seeking timely medical advice is essential for addressing any potential underlying issues related to abnormal uterine bleeding.



Dr Lopamudra Pradhan

Associate Consultant - Obstetrics & Gynaecology, Infertility Specialist

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