A strange visit from Aunt Flo can catch you off-guard, like an unexpected house guest on a moody Monday morning. Unlike a house guest though, an abnormal period can be a tricky thing to navigate, leaving you wondering what’s wrong.
While there’s no norm for menstrual cycles – yours might fluctuate from month to month in length, flow or frequency – it’s when they lose all semblance of a pattern, become excessively unpredictable, heavy or even debilitating, that it’s worth thinking about having yourself checked for an underlying medical condition.
Abnormal uterine bleeding can manifest in various ways. Some are outlined below.
If the frequency of your cycle differs drastically from month to month, your body may be telling you something. Monitor your period – if it’s less than 3 weeks or more than 5 weeks apart, meet a doctor.
On an average, a period lasts about 4 to 5 days. If you notice a flow of less than 2 days or one more than 7, something might be wrong.
If you could measure how much blood you’re losing every cycle, you’d ideally want to measure up to about 50-70 ml per cycle. Although it’s difficult to determine, a period with an excessive flow (one where you find yourself changing your pad every hour) could point to a problem.
This is a cause for concern. Speak to your doctor to investigate why Aunt Flo is making a pit stop in the middle of the month.
Bleeding after sex isn’t always a concern. But if it becomes a persistent problem, it could signal something more.
Bleeding during pregnancy doesn’t have to set off alarm bells. About 30-40 % of women experience some kind of bleeding when they’re pregnant and most of them go on to have healthy babies. However, bleeding can also be a sign of an ectopic pregnancy (a fertilized egg implanted outside the uterus) or a miscarriage. If you experience any kind of bleeding, reach out to your doctor.
If you’re bleeding after menopause, call your doctor to find out the course of action you need to take. Bleeding is a common outcome of menopause-led hormone replacement therapy, but it’s always a good idea to seek an expert opinion.
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Hormonal changes may be caused by:
Fibroids, polyps and adenomyosis are all uterine issues that trigger untimely bleeding. They can be addressed through medical or surgical intervention.
Clotting disorders, blood thinning medication, problems with the thyroid or liver, cervical or endometrial infections, and cervical, uterine or endometrial cancer can all lead to abnormal bleeding.
Your treatment will hinge on the root cause of your bleeding, and on whether you are planning any children in the future. If you’re menopausal, your doctor may recommend expectant management, to see if your symptoms subside without any intervention. Usually, medical options include hormone therapy, anti-inflammatory meds, tranexamic acid and the insertion of an intrauterine device. In more severe cases, surgery may be advised, in the form of endometrial ablation, a myomectomy, or a hysterectomy.
If you find yourself with persistent menstrual irregularities – between or during cycles – have yourself evaluated by a gynecologist. By seeking a diagnosis early, you can safeguard your health and keep any underlying conditions from snowballing into bigger problems. Most importantly, you can send Aunt Flo on a sabbatical and live life on your own terms.
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Hormonal changes due to uterine problems, birth control pills, IUDs or other medicines, emotional stress, physical fatigue, polyps, adneomyosis, fibroids and all uterine issues trigger uterine bleeding. Other factors that can cause abnormal bleeding are clotting disorders, liver, thyroid or cervical problems, or endometrial infections, endometrial or uterine cancer.
The treatment to stop uterine bleeding depends on the root cause and whether you plan to have children in the future. Treatment options include hormone therapy, insertion of an IUD, anti-inflammatory medications and tranexamic acid. If bleeding is severe, surgery, like a hysterectomy and myomectomy, may be recommended. If it is menopause related, then no interventions may be needed.
If you have soaked through a pad every hour for 2-3 hours, bleeding for more than a week, have severe pain, have heavy periods for more than 3 cycles, have spotting or bleeding between periods, abnormal bleeding returns, bleeding is severe and causes lightheadedness or weakness and your symptoms are frequent or severe.
The common tests recommended to diagnose abnormal bleeding are a pregnancy test to check for early pregnancy, blood tests, which include CBC and hormone levels. Pelvic ultrasound to check the reproductive organs for abnormal growths like fibroids, polyps or uterine abnormalities. Based on the results, further tests, like a hysteroscopic exam of the uterine lining and an endometrial biopsy, may be performed.
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