Definition

Bleeding that occurs between menstrual periods, or excessive bleeding that occurs during menstruation, is called abnormal uterine bleeding. It is normal for a woman's menstrual bleeding to last up to seven days. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signals get thrown off.

Lighter periods, or spotting between periods, may represent an endometrial lining that is unstable and leaking, either because hormonal levels don't adequately support it or because the lining may be too thick. A woman who bleeds for longer than a week, bleeds more than every 3 weeks or so, bleeds between periods, or bleeds excessively should see a doctor or other health care provider.

Causes

Abnormal uterine bleeding is a common clinical problem with myriad causes. Approximately 20% of cases of DUB occur in adolescents and 40% in women over 40. Obesity, excessive exercise, and emotional stress may be risk factors for DUB. Menstruation is often irregular or heavy during these times because, depending on hormonal levels, the ovaries may or may not release an egg. Another common cause of abnormal uterine bleeding is fibroid tumors. Sometimes a thyroid problem causes bleeding.

These problems can occur at any age, but the likely cause of abnormal uterine bleeding depends on your age. A common cause of abnormal bleeding in young women and teenagers is pregnancy. Any stress, such as traveling or a new job can interfere with ovulation. Fortunately this will usually be temporary, and rarely requires treatment.

Symptoms

In some cases, hemorrhage can be severe enough to require hospitalization and even blood transfusion. Common symptoms are :-

* Vaginal bleeding
* Abnormal menstrual periods
* Variable menstrual cycles
* Variable menstrual flow ranging from scanty to profuse
* Infertility
* Mood swings
* Hot flashes
* Vaginal tenderness
* Hirsuitism (excessive growth of body hair in a male pattern)

Treatment

There are medical, surgical, and combined methods of treating DUB. The choice of approach depends on the cause, severity of bleeding, patient's fertility status, need for contraception, and treatment options available at the care site.

Generally the first approach to controlling DUB is to use oral contraceptives that provide a balance between the hormones estrogen and progesterone.

Eat well-balanced meals with foods high in iron. Examples are leafy green vegetables, meat, liver, eggs, and whole-grain breads and cereals. Don't try to lose weight until the abnormal bleeding has stopped and your blood iron level is back to normal. In older women who may be approaching menopause, treatment may be including hormone supplementation or surgery to relieve symptoms.