Abnormal Uterine Bleeding ( AUB )

By peace | March 30, 2006

One in five women bleed so heavily during their periods that they have to put their normal lives on hold just to deal with the heavy blood flow.

Bleeding is considered heavy or abnormal if it interferes with normal activities. Blood loss during a normal menstrual period is about 2.5 ounces, but if you have AUB, you may bleed as much as 10 to 25 times that amount each month. You may have to change a tampon or pad every hour, for example, instead of three or four times a day. Heavy menstrual periods can be common at various stages of your life–during your teen years when you first begin to menstruate, and in your late 40s or early 50s, as you get closer to menopause.

If you are past menopause and experience any vaginal bleeding, discuss your symptoms with your health care professional right away. ANY vaginal bleeding after menopause isn’t normal and should be evaluated immediately by a health care professional.

Abnormal uterine bleeding can be caused by:

Hormonal imbalances
Structural abnormalities in the uterus
Medical conditions

Many women with excessive menstrual bleeding can blame their condition on hormones. Your body may produce too much or not enough estrogen or progesterone — known as reproductive hormones — necessary to keep your menstrual cycle regular.

For example, many women with abnormal uterine bleeding don’t ovulate regularly. Ovulation, when one of the ovaries releases an egg, occurs around day 14 in a normal menstrual cycle. Changes in hormone levels help trigger ovulation.

Certain medical conditions can cause abnormal uterine bleeding. These include:

Blood clotting disorders such as Von Willebrand’s disease, a mild-to-moderate bleeding disorder
Idiopathic thrombocytopenic purpura (ITP), a bleeding disorder characterized by too few platelets in the blood
Liver or kidney disease
Leukemia
Medications, such as anticoagulant drugs such as Plavix (clopidogrel) or heparin and some synthetic hormones.

Other gynecologic conditions that may be responsible for heavy bleeding include:

Complications from the Copper-T IUD
Miscarriage
Ectopic pregnancy, which occurs when a fertilized egg begins to grow outside your uterus, typically in your fallopian tubes
Chronic medical problems, such as diabetes, lupus or sarcoidosis

Other causes of excessive bleeding include:

Fibroids (However, fibroids don’t always cause excessive bleeding. In fact, about half of all women who have fibroids don’t have any symptoms at all.)
Infection
Pre-cancerous conditions
Amenorrhea — No Bleeding.

You may also have experienced the opposite problem of heavy menstrual bleeding — no menstrual periods at all. This condition, called amenorrhea, or the absence of menstruation, is normal before puberty, after menopause and during pregnancy. If you don’t have a monthly period and don’t fit into one of these categories, then you need to discuss your condition with your health care professional.

There are two kinds of amenorrhea: primary and secondary.

Primary amenorrhea is diagnosed if you turn 18 and haven’t menstruated. It’s usually caused by some problem in your endocrine system, which regulates your hormones. This medical condition can be caused by a number of things, such as a problem with your ovaries or an area of your brain called the hypothalamus or genetic abnormalities. Delayed maturing of your pituitary gland is the most common reason, but you should be checked for any other possible reasons.
Secondary amenorrhea is diagnosed if you had regular periods, but they suddenly stop for three months or longer. It can be caused by problems that affect estrogen levels, including stress, weight loss, exercise or illness.

Additionally, problems affecting the pituitary gland (such as elevated levels of the hormone prolactin) or thyroid (including hyperthyroidism or hypothyroidism) may also cause secondary amenorrhea. This condition can also occur if you’ve had an ovarian cyst or had your ovaries surgically removed.