Abnormal uterine bleeding: what it is, causes, symptoms and treatment

The problem often negatively affects the physical, emotional, sexual and professional aspects of people with a uterus

Fibroids, polyps, clotting problems. There are many reasons why people with a uterus can develop abnormal uterine bleeding (AUB). E even those who don't live with any associated illnesses can experience worrying blood loss during and outside the menstrual period

In some cases, heavy bleeding affects physical, emotional, sexual and professional aspects so negatively that it worsens patients' quality of life to the point of preventing them from carrying out everyday activities and forcing them to undergo emergency treatment or highly invasive surgery, such as total removal of the uterus (hysterectomy).

But the good news is that, in most cases, there is conservative treatment - in other words, treatment that avoids invasive procedures. The most important thing is to discover the cause of the bleeding in advance.

What is abnormal uterine bleeding (AUB)?

A classification developed by the International Federation of Gynecology and Obstetrics (Figo) called "Palm-Coein" considers the following to be the main causes of abnormal uterine bleeding - excluding the possibility of pregnancy:

• Structural causes: Plipstick, Adenomyosis, Leiomyoma, Malignments;
• Non-structural causes: Coagulopathy, Ovulatory, Endometrial, Iatrogenic, Nnot classified.

In patients with a low risk of endometrial cancer, with normal exams, and excluding natural causes, it is possible to treat the bleeding with medication or surgery. However, structural lesions classified as "Palm" have specific treatment, according to each diagnosis. Let's take a closer look.

When is bleeding considered abnormal?

According to the gynecologist Morgana Domingues, a consultant at Biolab Farmacêutica, says that in a menstrual cycle considered "normal", blood loss is around 70 millimeters to 80 ml. "In cases of heavy bleeding, this volume can double," she says.

Signs that can be observed by the patient herself are blood leaking through clothing, excessive changing of pads in a short period of time (two to three hours), the need to change pads at night and the loss of clots.

Difference between abnormal uterine bleeding and irregular menstruation

Irregular menstruation is a type of abnormal uterine bleeding. According to the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), menstruation is considered "normal" when the blood flow lasts up to eight days and the cycle varies between 24 and 38 days. Any bleeding outside of these characteristics is already considered abnormal.

In fact, one of the possible causes of the "irregularity" of menstruation is the polycystic ovary syndromeThis is a condition which, due to its complexity, is hardly diagnosed in the early years of a teenager's menstruation.

"As menstrual irregularity is common in the first few years after menstruation begins, diagnosing the syndrome is more difficult at this stage, requiring long-term follow-up and reassessments from time to time to conclude the diagnosis," says Febrasgo.

"Menstrual irregularity is a specific term for a change. It occurs when the intervals become different or when the patient menstruates more times a month or less often, or completely irregularly and without predictability. So, in these cases, when we talk about menstrual irregularity, we're talking more about the irregular frequency with which menstruation occurs," says gynecologist Morgana Domingues.

What are the causes of abnormal uterine bleeding?
Like polycystic ovary syndrome, abnormal uterine bleeding can be caused by different diseases known to medicine. According to Morgana, it is possible to have increased bleeding due to polyps, which are nodular structures that appear in the endometrium, and adenomyosis, which is another alteration of the endometrium that affects younger women and causes, in addition to bleeding, increased menstrual cramps.
In addition, fibroids, coagulation disorders, changes in ovulation and malignant diseases can also cause increased flow and frequency of bleeding.

"There are also those patients who have no comorbidities, no associated illnesses. Then we say it's abnormal uterine bleeding with no defined or unclassified cause," concludes the specialist.

Warning signs and symptoms

Patients with abnormal uterine bleeding usually have associated symptoms such as:

• More intense cramps during menstruation;
• A feeling of pressure in the pelvic region;
• Malaise;
• Tiredness;
• Anemia.

When the situation develops into anemia, it is possible to feel weak even outside the menstrual period, as well as palpitations, tachycardia and malaise when performing physical activity. "The patient who experiences SUA ends up having a loss of quality of life, not just because of the increased bleeding, but because of all these symptoms," says Morgana Domingues.

Check out the full article here: Abnormal uterine bleeding: what it is, causes, symptoms and treatment