Abnormal uterine bleeding is bleeding that occurs at unexpected intervals other than menstrual bleeding. This type of bleeding is observed independently of normal menstrual bleeding and may be short or long in duration depending on the cause. To better understand what abnormal bleeding is, let's first talk about what normal bleeding is:

Normal Menstruation:

Normal menstruation, that is, the normal menstrual cycle, is a cycle that lasts at least 2 to 8 days with intervals of 21 to 35 days and generally requires the use of 2 to 4 pads per day. Generally, when regular menstruation is mentioned, menstrual bleeding that occurs every 28 days is considered, but due to various reasons, it can also be observed at shorter or longer intervals such as 21-35 days.

Abnormal uterine bleeding may occur as follows:

– Observation of spotting or bleeding between two periods
– Bleeding problem after sexual intercourse
– Observation of bleeding that is longer than the normal menstrual cycle
– More bleeding than normal menstrual bleeding
– Bleeding after menopause

Causes of Abnormal Uterine Bleeding:

1) Infections: Pelvic infections can sometimes manifest themselves as bloody discharge along with inflammation.
2) Benign pelvic lesions: Lesions due to vaginal trauma, polyps seen in the cervix or endometrium, cervical erosions, myomas, adenomyosis, etc. are problems that can cause abnormal bleeding.
3) Systemic diseases: For example, bleeding disorders, endocrinological disorders and liver-related problems can cause abnormal bleeding.
4) Female Genital System Cancers: The first thing to rule out in abnormal bleeding, especially in women who are about to enter or have entered menopause, is cancer.
5) Weight changes: Excessive weight gain or loss can also cause abnormal bleeding.

Abnormal bleeding may occur for different reasons. Therefore, it is not easy to describe the symptoms of this type of bleeding in a single way. Bleeding may be heavy or mild. It may last short or long. If we talk about the main features in general, it may be possible to come across the following elements:

– Unexpected bleeding between two periods
– Menstrual cycles that are much shorter or longer than normal
– Observation of more severe bleeding than normal and the appearance of particles such as clots along with the bleeding.
– If abnormal bleeding is observed due to hormonal changes, vaginal dryness, hair growth and menopause-like symptoms may occur in parallel.

If severe bleeding occurs that is much higher than normal, problems such as anemia may develop in women. Therefore, it is very important to get an opinion from your doctor and to make the correct diagnosis in a timely manner.

Tests That Can Be Done for Abnormal Uterine Bleeding:

In the first place, pelvic examination and PAP test should be considered (in the non-bleeding period). And also:

– Ultrasound examination
– Complete blood count
– Coagulation status
– Liver functions
– Hormone values
- Pregnancy test
– Thyroid functions will be a guide in the first place.

In order to ensure early diagnosis, it is recommended that every woman be examined by a gynecologist once a year, without waiting for abnormal bleeding complaints, and to have a Smear test, which is a cervical cancer screening test.

Stay well.

Op. Dr. Zeynep Tasargol
Gynecology and Obstetrics Specialist
In Vitro Fertilization Specialist

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