Irregular uterine bleeding

Irregular Uterine Bleeding is a condition characterized by abnormal bleeding from the uterus, which can vary in flow, duration, and timing, and is not associated with regular menstruation. This condition can affect women of any age but is more common at the beginning of the reproductive years and approaching menopause.

Causes

Irregular uterine bleeding can be caused by a variety of factors, including but not limited to:

• Hormonal imbalances: Fluctuations in estrogen and progesterone can disrupt the normal menstrual cycle.
• Uterine fibroids: Noncancerous growths in the uterus can lead to heavy or prolonged menstrual bleeding.
• Polycystic ovary syndrome (PCOS): A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
• Endometrial polyps: Small benign lumps on the lining of the uterus can cause irregular bleeding.
• Adenomyosis: A condition where the inner lining of the uterus breaks through the muscle wall of the uterus.
• Thyroid disorders: Both hyperthyroidism and hypothyroidism can cause menstrual irregularities.
• Bleeding disorders: Conditions that affect the blood's ability to clot can lead to abnormal uterine bleeding.
• Medications: Certain medications, including blood thinners and hormonal treatments, can affect menstrual bleeding.
• Infections: Pelvic inflammatory disease (PID) or other infections can cause irregular bleeding.
• Pregnancy complications: Ectopic pregnancy or miscarriage can result in abnormal bleeding.

Symptoms

Symptoms of irregular uterine bleeding include:

• Bleeding or spotting between periods
• Heavy menstrual bleeding
• Bleeding after sex
• Menstrual cycles that are longer than 35 days or shorter than 21 days
• Bleeding after menopause

Diagnosis

Diagnosis of irregular uterine bleeding involves a thorough medical history, physical examination, and may include:

• Blood tests to check for hormonal imbalances, thyroid problems, and pregnancy.
• Ultrasound to examine the uterus, ovaries, and pelvis.
• Endometrial biopsy to take a small sample of the lining of the uterus.
• Hysteroscopy to inspect the inside of the uterus.
• Sonohysterography to examine the inside of the uterus after filling it with fluid.

Treatment

Treatment for irregular uterine bleeding depends on the cause, age, and whether the woman wishes to become pregnant. Options may include:

• Hormonal therapy: Birth control pills, vaginal rings, or hormone-containing IUDs can help regulate menstrual cycles.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen can reduce menstrual blood loss.
• Tranexamic acid: A medication that helps reduce heavy menstrual bleeding.
• Surgery: Procedures like endometrial ablation, removal of polyps or fibroids, or hysterectomy may be considered in severe cases.

Prevention

While not all cases of irregular uterine bleeding can be prevented, maintaining a healthy lifestyle, managing chronic conditions, and regular check-ups with a healthcare provider can help minimize risks.