Abnormal bleeding or a disrupted menstrual period can be a source of anxiety and concern. Most women will experience at least one episode of abnormal menstrual bleeding when their period is delayed, is lighter than usual, or is heavier than expected. These are usually one-off events that come and go without issue. However, there are some instances when abnormal menstrual bleeding is something that requires further investigation by your doctor or OBGYN.
What Is Abnormal Menstrual Bleeding?
The best way to define abnormal menstrual bleeding is to think about what a normal menstrual cycle looks like for you. This will differ for every woman. Any variation from what you usually experience may be considered abnormal bleeding. This might include:
- A menstrual period that lasts longer than seven days (menorrhagia)
- A menstrual period that is heavier than expected (i.e., needing to change a pad or tampon every hour or two)
- Bleeding in between periods (i.e., small spotting of small amounts of blood between periods)
Abnormal Menstrual Bleeding: Signs and Symptoms
In addition to the abnormal bleeding, it is also essential to consider if the bleeding is occurring alongside other symptoms, such as
- Severe pelvic pain or cramping
- Fatigue
- Back pain
If you notice one or more of these symptoms in addition to the abnormal menstrual cycle, it is important to speak to your doctor as soon as possible.
Common Causes of Abnormal Menstrual Bleeding
Several factors can contribute to abnormal menstrual bleeding:
- Uterine Fibroids are non-cancerous growths of the uterus.
- Endometriosis is a medical condition in which cells that usually line the inside of the uterus (the endometrium) begin to grow on the outside of the uterus instead.
- Polycystic ovarian syndrome (PCOS) is a medical condition caused by an imbalance of the reproductive hormones estrogen and progesterone, which can lead to symptoms of irregular periods (i.e., infrequent, heavy, or prolonged menstrual cycle), acne, excess facial and body hair, weight gain, or infertility.
- Pelvic inflammatory disease (PID) is the infection of a woman’s reproductive organs. It is a complication often caused by sexually transmitted diseases such as chlamydia or gonorrhea. PID is a serious medical condition that should be treated by a doctor as soon as possible.
- Sexually Transmitted Infections: In some cases, sexually transmitted infections (STIs) such as chlamydia and gonorrhea may cause abnormal vaginal bleeding.
- Non-Sexually Transmitted Infections, such as yeast or bacterial vaginosis, are infections or inflammation of the vagina, known as vaginitis, may cause abnormal vaginal bleeding.
Cancer
The vast majority of abnormal bleeding events are not related to cancer. Still, in a small number of cases, irregular menstrual bleeding may be a sign of cancer in the reproductive organs. That’s why all cases of abnormal vaginal bleeding must be taken seriously and discussed with a medical professional.
Other Causes of Abnormal Bleeding:
- Medications – some medications, such as birth control pills or hormone replacement therapy, can cause abnormal vaginal bleeding.
- Possible pregnancy – women may experience episodes of light vaginal bleeding in the early stages of pregnancy. If pregnancy is a possibility, a home pregnancy test can be taken.
Abnormal Menstrual Bleeding Diagnosis
Diagnosing abnormal menstrual bleeding involves a thorough evaluation by your doctor. They will take a complete medical history and inquire about your menstrual history, obstetric history, and general medical health. If required, this is usually accompanied by a medical exam and routine diagnostic tests. Diagnostic tests such as a blood test or ultrasound scan may be used to rule out other possible factors.
Abnormal Menstrual Bleeding Management
Your specific diagnosis will determine the management of abnormal menstrual bleeding. Once a diagnosis is given, options can be discussed with your doctor in terms of helping you choose the best course of action. Your unique circumstances and preferences will always guide all management options. A range of management options may include one or more of the following:
- Hormonal Birth Control – Some contraceptives or hormone-releasing IUDs can be used to help regulate menstrual cycles and reduce heavy bleeding.
- Medications: Depending on the cause, medications may treat infections and pain or alleviate heavy bleeding during menstruation.
- Surgical Procedures – In cases where required, procedures like endometrial ablation, where the uterine lining is removed, or hysterectomy (removal of the uterus) may be recommended. This is generally reserved for severe cases when other treatments are not effective.
Abnormal menstrual bleeding can be disruptive and concerning, impacting a woman’s quality of life. However, recognizing the signs and seeking timely medical intervention is crucial for effective management. Be sure to speak to your doctor if you have been experiencing abnormal menstrual bleeding.
