ABNORMAL BLEEDING

What is abnormal bleeding?

Abnormal uterine bleeding, AUB in short, is a common concern affecting women of all ages. 

AUB is a term which refers to menstrual bleeding or periods of abnormal:

  • Quantity 
  • Duration 
  • Pattern

If you’re experiencing abnormally heavy or prolonged menstrual bleeding, or your period doesn’t follow a normal pattern, it’s important to find the cause.  

What is normal menstrual bleeding?

AUB can be caused by a physical condition affecting the uterus or womb, such as:

  • Fibroids 
  • Polyps 
  • Adenomyosis 

Fibroids are abnormal growths that form in the muscle of the womb or uterus. The majority of fibroids are small and don’t cause any symptoms. Large fibroids can cause heavy menstrual bleeding.

Polyps are non-cancerous growths of the lining of the uterus that can cause abnormal or heavy bleeding. Most polyps are benign or non-cancerous but a small proportion can be related to precancerous or cancerous changes. 

Adenomyosis is a common cause of painful and heavy periods. It’s a condition in which the lining of the uterus has invaded into the muscle of the uterus, and causes the uterus to grow larger. A significant proportion of women with adenomyosis also have pelvic endometriosis.  

It’s important to rule out cervical cancer as a cause of bleeding if you’ve experienced bleeding after intercourse and/or bleeding between periods.

Endometrial cancer is another possible cause of heavy bleeding, which must be investigated. Cancer of the endometrium often presents with either post-menopausal bleeding or irregular heavy periods with intermenstrual bleeding if you haven’t yet gone through menopause.

Other causes include:

  • Ovulatory dysfunction – the ovary doesn’t release an egg each month 
  • Hemostasis disorders – blood clotting disorder  
  • Medications

 

We’ll start talking about your detailed medical history, specifically your pattern of bleeding and any previous gynaecological issues. 

It may be necessary to have a Cervical Screening Test and colposcopy if the bleeding is suspected to be coming from the cervix. In most cases, a pelvic ultrasound is requested to have a closer look at the uterus and the ovaries. Your GP may have already requested one for you prior to the referral.

In addition, you may need to get some routine blood tests to look at the blood counts, hormone levels and, in some cases, the iron levels in your body.

Do I need a biopsy?

We may recommend a procedure called a hysteroscopy and a biopsy of the lining of your uterus if the ultrasound is abnormal or if a cancerous change is suspected. 

A hysteroscopy is a procedure to look inside the uterus using a small camera called a hysteroscope. I’ll take a small sample from the lining of the uterus. Any abnormalities like polyps are removed at the same time using a device called Myosure. 

Will I need more treatment after the biopsy?

I may recommend further treatment or surgery based on the results of the biopsy. 

Want to make an appointment?