- Abnormal uterine bleeding (AUB) includes menorrhagia (menses too heavy), metrorrhagia (bleeding in between menses) and hypermenorrhea (menses too long). The term may also be used to describe amenorrhea or absence of menstrual periods.
- If you are between the ages of 40 and 50 you're, you're at a higher risk for AUB. Fifty percent of patients with AUB are older than 45. Before menopause, your periods may suddenly become lighter or heavier because you are ovulating less often. If you have just begun to menstruate, you may also experience AUB.
- Sometimes abnormal bleeding is caused by hormonal problems, which is called dysfunctional uterine bleeding. As many as 75 percent of women with excessive menstrual bleeding fall into this category. Hormonal imbalances occur when your body produces too much or not enough of certain hormones.
- Aside from hormonal problems, there are many other causes of abnormal uterine bleeding. They include:
- certain birth control methods, such as IUDs (intrauterine devices) or birth control pills
- infection of the uterus or cervix
- uterine fibroids
- About 20 percent of all hysterectomies are performed to stop AUB and it's the only treatment that completely guarantees the bleeding will stop. This is a radical surgical intervention where your uterus is removed and you will no longer be able to have children after this procedure.
- blood clotting problems
- some types of cancer, including uterine, cervical and vaginal
- chronic medical problems, such as hypo- and hyperthyroidism, lupus and diabetes
- Many women don't have any periods at all. Called amenorrhea, or the absence of menstruation, this condition is normal before puberty, after menopause and during your pregnancy. There are two kinds of amenorrhea - primary and secondary. Primary amenorrhea is diagnosed if you reach the age of 18 and haven't yet begun to menstruate. Secondary amenorrhea is diagnosed if you've had regular periods, but then they suddenly stop.
- Pain from menstrual cramps is caused by contractions of your uterus triggered by prostaglandins, hormone-like substances found in many different types of tissue. They can cause diarrhea because they also speed up contractions in your intestines. If you are having severe menstrual pain, you might also find you have some diarrhea or an occasional feeling of faintness where you suddenly become pale and sweaty.
- Both medication and surgery are used to treat AUB. Typically, less invasive therapies should be considered first. Treatment choices depend on your age, your desire to preserve fertility, and the cause of the bleeding (dysfunctional or structural).
- Premenstrual syndrome (PMS) is a term commonly used to describe a wide range of severe physical and psychological symptoms that some women experience seven to 10 days prior to the start of their periods and end just after. To qualify as PMS symptoms, the symptoms must fit a pattern: they are associated with the menstrual cycle, they become more severe as the menstrual cycle progresses and they must be present for at least three consecutive menstrual cycles.
- Premenstrual dysphoric disorder (PMDD) is different from the more common PMS — it's far more severe. Women who experience PMDD (about five to seven percent of all women) say that it significantly interferes with lives. The most common symptoms of PMDD are heightened irritability, anxiety and mood swings. Women who have a history of major depression, postpartum depression or mood disorders are at higher risk for PMDD than other women.
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