Abnormal Uterine Bleeding (Causes & Treatment)

Bleeding is a natural bodily function that helps us heal from wounds and maintain our overall health. However, when bleeding becomes abnormal in frequency, duration, or intensity, it may indicate an underlying medical condition. Abnormal bleeding can affect both men and women and can occur at any age. In this article, we will explore the causes, symptoms, and when to seek medical attention for abnormal bleeding.


Understanding Abnormal Bleeding and the main causes

Abnormal bleeding refers to any bleeding that deviates from what is considered normal for an individual. It can manifest in various ways, such as prolonged bleeding, heavy or excessive bleeding, irregular menstrual cycles, bleeding between periods, bleeding after sex, or postmenopausal bleeding in women. In men, abnormal bleeding may present as blood in the urine or stool or bleeding from the penis.

There are numerous potential causes of abnormal bleeding, ranging from minor issues to more serious medical conditions. Some common causes include:

  • Hormonal Imbalances: Fluctuations in hormone levels, such as those experienced during puberty, perimenopause, or because of certain medications or medical conditions, can lead to irregular bleeding.
  • Uterine Fibroids: These noncancerous growths in the uterus can cause heavy or prolonged menstrual bleeding.
  • Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder that affects women of reproductive age. Irregular periods or heavy bleeding can occur due to imbalances in estrogen and progesterone levels.
  • Endometrial or Cervical Polyps: These benign growths in the uterus or cervix can lead to abnormal bleeding, particularly postcoital bleeding.
  • Infections: Certain infections, such as pelvic inflammatory disease (PID) or sexually transmitted infections (STIs), can cause abnormal bleeding.
  • Blood Disorders: Conditions like von Willebrand disease, hemophilia, or platelet disorders can lead to excessive bleeding or abnormal clotting.
  • Certain Medications: Blood thinners, hormonal contraceptives, or medications that affect clotting can sometimes result in abnormal bleeding.
  • Uterine or Cervical Cancer: Abnormal bleeding can be an early sign of cancer in the reproductive organs.


Symptoms and When to Seek Medical Attention

It is important to pay attention to the following symptoms of abnormal bleeding and consult a healthcare professional if they occur:

  • Heavy or prolonged bleeding that requires changing pads or tampons frequently (more than once every two hours) or leads to anemia symptoms such as fatigue and weakness.
  • Bleeding between periods or after menopause.
  • Severe pelvic pain or cramping accompanied by abnormal bleeding.
  • Passing large blood clots during menstruation.
  • Blood in the urine or stool.
  • Abnormal bleeding in men, such as from the penis or blood in the semen.

If you experience any of these symptoms, it is crucial to seek medical attention promptly. A healthcare provider will perform a thorough evaluation, which may include a physical examination, blood tests, imaging studies, or a biopsy to determine the underlying cause of the abnormal bleeding.


Bleeding Disorder Diagnosis

When diagnosing a bleeding disorder, a doctor will typically consider various factors, including the individual’s medical history, family history of bleeding disorders, and the symptoms they are experiencing. Some common bleeding disorders include:

  • Hemophilia: A genetic disorder in which the blood lacks certain clotting factors, leading to excessive bleeding, often into joints and muscles.
  • von Willebrand disease: Another inherited disorder that affects the blood’s ability to clot. It is caused by a deficiency or dysfunction of the von Willebrand factor, a protein involved in clotting.
  • Platelet disorders: Conditions in which the blood lacks an adequate number or functioning of platelets, the cells responsible for clotting. Examples include immune thrombocytopenic purpura (ITP) and thrombocytopathy.

To diagnose a bleeding disorder, the doctor may perform a variety of tests, including:

  • Blood tests: These may include a complete blood count (CBC) to assess the number and quality of blood cells, clotting factor tests, and tests to evaluate platelet function.
  • Bleeding time test: This test measures the time it takes for a small skin puncture to stop bleeding.
  • Genetic testing: In some cases, genetic testing may be necessary to identify specific genetic mutations associated with bleeding disorders.
  • Coagulation studies: These tests evaluate the blood’s ability to clot properly, such as the prothrombin time (PT) and activated partial thromboplastin time (aPTT).

It’s important to remember that the information provided here is not a substitute for professional medical advice. If you suspect a bleeding disorder, please consult a healthcare professional who can evaluate your symptoms, perform the necessary tests, and provide an accurate diagnosis.


Treatment for Abnormal Bleeding

Abnormal bleeding can occur for various reasons and in different parts of the body. Treatment options for abnormal bleeding depend on the underlying cause and may include:

  • Hormonal medications: If abnormal bleeding is due to hormonal imbalances, such as in cases of irregular menstrual cycles or uterine fibroids, hormonal medications like birth control pills, hormone replacement therapy, or gonadotropin-releasing hormone (GnRH) agonists may be prescribed to regulate the menstrual cycle and reduce bleeding.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs like ibuprofen or naproxen can help reduce heavy bleeding and relieve pain associated with abnormal bleeding. They work by inhibiting the production of prostaglandins, which are responsible for uterine contractions and increased blood flow.
  • Tranexamic acid: Tranexamic acid is an antifibrinolytic medication that helps prevent the breakdown of blood clots. It is commonly used to treat heavy menstrual bleeding or bleeding disorders. It can be taken orally or as an intravenous injection.


  • Dilation and curettage (D&C): In some cases, if abnormal bleeding is caused by the presence of tissue in the uterus, a D&C procedure may be performed. During this procedure, the cervix is dilated, and the lining of the uterus is scraped to remove any abnormal tissue.
  • Endometrial ablation: This procedure involves the removal or destruction of the lining of the uterus (endometrium). It is usually performed for women with heavy menstrual bleeding who do not desire future fertility. The methods used for endometrial ablation include laser therapy, thermal ablation, radiofrequency ablation, or freezing.
  • Surgical interventions: In certain cases, surgery may be necessary to address the underlying cause of abnormal bleeding. For example, if fibroids or polyps are causing the bleeding, they may be surgically removed. In severe cases, a hysterectomy (removal of the uterus) may be recommended.
  • Blood transfusion: If abnormal bleeding leads to significant blood loss and anemia, a blood transfusion may be required to restore blood volume and replenish red blood cells.

It’s important to note that treatment options for abnormal bleeding should be discussed with a healthcare professional who can evaluate the individual’s specific situation and recommend the most appropriate course of action.

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Dr. Adeeb AlShahrour

Dr. Alshahrour is a highly skilled obstetrician and gynecologist who provides compassionate care to women of all ages. He has years of experience in the field, and is dedicated to helping his patients achieve the best possible health outcomes.