Minor variations in the menstrual cycle like changes in amount or duration of flow or even spotting between periods is common. But if it persists and you experience bleeding that is very different from your regular periods, it calls for a visit to your gynecologist.
Any uterine bleeding that is not like your regular menstruation and which persist for months can be considered abnormal uterine bleeding. Changes in the duration of bleeding, the amount of blood loss, spotting off and on, passage of clots forms the spectrum of abnormal uterine bleeding. Most women in their reproductive years face some changes in their menstrual cycle and it necessarily does not indicate any underlying problem. But you must consult your doctor when it happens for consecutive months or starts to bother you at any level. These can be signs of some underlying conditions. AUB is more commonly found around menarche (the start of periods) and the years leading up to menopause.
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One of the commonest reasons for AUB is stress. Physical or mental stress can alter your period cycle. Other causes are excessive weight gain, unhealthy lifestyle, cyst and tumors in the ovaries and uterus, fibroid, polyps, PCOD and diseases like hypothyroidism and hyperprolactinemia. Rarely bleeding disorders and uterine cancer can be the reason.
A detailed history of the change in the menstrual cycle is the first and most important step in understanding the root cause. This is aided by a proper physical examination. If required, blood tests and ultrasound are recommended. Amongst other findings a pelvic ultrasound checks for the endometrial thickness of the uterus which is one of the factors to consider for the possibility of uterine cancer.
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AUB treatment depends on the diagnosis.
First line of treatment is healthy lifestyle changes. Most of them respond to eating healthy, regular exercise and weight loss. Second line of treatment is Medical management in the form of oral hormones and intrauterine devices. If that doesn't work then we consider surgical management. Surgical options include hysteroscopy, laparoscopy and hysterectomy.
In case of thickened endometrium uterine cancer is a possibility and, endometrial biopsy is the first recommendation. That guides us on planning the further treatment.
Early diagnosis and proper management prevents complications. Consult your gynecologist when you experience any persistent abnormal uterine bleeding.
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