What Is Abnormal Uterine Bleeding?

Bleeding during your period is normal. This menstrual flow should last from four to seven days and only occur roughly every four weeks. Women who have abnormal uterine bleeding (AUB), however, can face sporadic bleeding at unusual times, longer or heavier periods and a list of other problems. What does abnormal uterine bleeding mean? Take a closer look at AUB, potential causes and when to see a doctor. 

How Common Is Abnormal Uterine Bleeding?

Abnormal uterine bleeding is not always reported. Nevertheless, some estimates state that anywhere between 10 and 35 percent of women globally may experience AUB. However, these numbers could potentially be higher because issues are so underreported. AUB is most common at the start of menstruation (menarche) and when menstruation is nearing its end (perimenopause).

What Are the Signs and Symptoms of Abnormal Uterine Bleeding? 

AUB signs vary both in terms of when the bleeding occurs and how much bleeding occurs. Typical signs that can be considered abnormal bleeding include: 

• Heavy bleeding during menstruation 
• Bleeding or spotting at odd times, such as after sex or between periods 
• Experiencing longer-than-normal periods (7 days or more) 
• Experiencing inconsistent or unpredictable menstrual cycles; cycles last less than 21 days or longer than 35 days or the length of your cycle varies by a week or more month to month
• Bleeding after menopause 
• Not having a menstrual bleeding cycle for 3 to 6 months 

It is important to note, AUB does not occur at any point during pregnancy. Bleeding during pregnancy should be discussed with your doctor because it can have different causes and must be evaluated and treated appropriately to protect the pregnancy. 

When Should You Talk to a Doctor About Abnormal Uterine Bleeding?

Anytime you deal with abnormal uterine bleeding characterized by the signs mentioned above, it is a good idea to talk to your doctor. It is common for AUB to affect your quality of life. For example, you should never have to avoid going out because you are bleeding so heavily or not sure when the bleeding will start. However, some situations may need to be addressed quicker, such as: 

• Passing large blood clots (quarter-size or bigger) 
• Bleeding so much that you soak at least one pad or tampon every 1 to 2 hours
• Bleeding between your usual period that persists for more than 7 days 
• Experiencing anemia symptoms, such as shortness of breath, fatigue or weakness 
• Experiencing pica symptoms, such as paleness, hair loss or the urge to ingest things like paper or dirt 

What Causes Abnormal Uterine Bleeding?

Every menstrual cycle is different for every woman, and a lot of factors can affect uterine bleeding, including various medical conditions, age, and even emotional stress. For most women, AUB is caused by general hormonal imbalances, common in the teenage years or for women nearing menopause. Below is a look at some of the most probable causes of abnormal uterine bleeding by age group. 

Teens, 20s and 30s

For younger women, AUB may occur when ovulation does not happen as it should during the menstrual cycle. When the ovaries do not release an egg, the lining of the uterus grows thicker than usual, which equates to heavier bleeding during a period. Hormonal imbalances during this time may also mean disruptions in the menstrual cycle. Essentially, the body is not triggered to shed uterine lining at the right time, which leads to irregular spotting or bleeding.

The 40s and Early 50s

As menopause approaches, the body can skip ovulation altogether. This can lead to AUB, including irregular bleeding or inconsistent period bleeding flow. Thickening of the uterine walls is also related to AUB during this time, and this should not be overlooked, as uterine lining changes can sometimes be related to uterine cancer. While most cases of lining changes are simply a natural part of aging, it is important to discuss problems with a doctor to ensure proper evaluation. 

After Menopause

Post-menopause AUB can be more concerning because it may be a sign of uterine or endometrial cancer in older women. However, other causes can be to blame, such as undergoing hormone replacement therapy. In any case, any issue with bleeding after menopause should be discussed with your doctor. 

Other Potential Causes of AUB 

• Uterine fibroids or polyps 
• Polycystic ovary syndrome (PCOS)
• Excess weight gain or weight loss 
• Taking hormone-based birth control  
• Infections of the cervix or uterus 
• Bleeding disorders, such as problems with blood clotting 

What Does Abnormal Uterine Bleeding Mean? A Final Word From Coyle Institute 

While abnormal uterine bleeding is common, the problem can be a symptom of a larger but treatable issue. AUB may be related to anything from a hormone imbalance or uterine fibroids to bleeding disorders or infection. Therefore, obtaining a proper diagnosis is important. If you suspect you are experiencing AUB, reach out to the Coyle Institute to schedule an appointment at 850-637-8258.