Abnormal Uterine Bleeding

Hello, I am Dr Pallavi Vasal consultant Obstetrics and gynaecologist. Today I will be talking about abnormal uterine bleeding so, abnormal uterine bleeding is bleeding anywhere from the genital tract which is unusual. It can occur as in the form of spotting or bleeding before the periods or in between periods, after sex or it can be longer than a normal period, heavier than normal or if the bleeding is happening after menopause. If we divide the causes of abnormal uterine bleeding if we see young girls who have it as they started with the menstrual period. It usually because of trauma and any foreign body, irritation of the genital tract or an urine tract infection, but we have to be very careful about this sexual abuse, in young girls if it is happening, In adolescence during the teenage it can be during the first few years of the after the attaining the menstrual cycles it can happen in the first few years. This is because of the hormonal changes, which are happening in the girl’s body. But in that case, also we need to rule out any kind of pregnancy, infection any bleeding disorders or any other medical illness. In the reproductive age, group pregnancy has to be ruled of first because that is the most common cause of the abnormal bleeding in the reproductive age group. Then it can be because of the abnormal gain in weight or sudden loss in weight, intake off or any hormones or in use of any contraceptive intrauterine contraceptive virus, in pre-menopause that is between the age of 40 to 50 years of age, it can be because of the Ovulatory dysfunction that means there they are changes in the hormones when the periods are about to end because of that the hormones they are dysregulated that lead to abnormal bleeding. It can be because of fibroid in the womb or it can be because of the increased thickness of the lining of the womb or the growth of the endometrial polyp. So pregnancy precancerous or the cancers of the cervic, so any kind of cancers this also needs to be taken care off. And in the postmenopause, so in the postmenopause it is very important to see if a lady has started bleeding again after attaining the menopause, this leads to being because we need to rule out cancer because it is very scary and if it is diagnosed at a very early stage it can be treated very nicely. The another most common cause in menopause age group is atrophic days, thinning of the lining of the vagina and the womb sometimes that leads to irregular bleeding or growth of polyp for fibroid or infection in the uterus that can also lead to abnormal bleeding in women who are menopause. Now the symptoms as we discussed the symptoms are like bleeding or spotting in between the periods, the periods are less than 26 days more than 35 days heavy bleeding or prolonged bleeding during the periods. As we go ahead you need to go to a gynaecologist get a general checkup done along with the abdominal examination and the internal examination and then usually ultrasound is very much required in these cases to rule out anything which can be treated by surgery or the treatment can be with the medicines. Now a couple of blood test like CBC, the complete blood count, the hormonal profile, the infection screen, the pregnancy test all these needs to be done. The treatment is based on the cause, if there is no significant pathology identified then hormonal correction is required and this is done with hormonal therapy, which can be oral, injectable or in the form of intrauterine contraceptive device or if there is a particular cause like fibroid or polyp, then that needs to be removed through the surgery. In menopause age group we advise endometrial biopsy even if there is nothing but significant in the ultrasound because we need to rule out cancer in a patient who has attained menopause but still are having periods. So the important things I would say is too young girls especially avoid taking an excess of hormones or you should maintain a healthy weight and healthy lifestyle and there is very much there is a very high intake of I pills and adolescent that should be avoided because they have screwed up your periods and leads to irregular bleeding. For further queries, you can talk to me or connect me through Lybrate.