Abnormal Uterine Bleeding: Causes & Treatment
A doctor-reviewed guide to understanding heavy or irregular menstrual bleeding.
What is Abnormal Uterine Bleeding?
Abnormal uterine bleeding (AUB) refers to any menstrual bleeding that differs from a typical cycle in terms of frequency, duration, regularity, or amount. This includes heavy periods, prolonged bleeding, bleeding between periods, or bleeding after menopause — all of which warrant a gynecological evaluation.
Common Causes
- Hormonal imbalances, especially involving estrogen and progesterone
- Uterine fibroids or polyps
- Polycystic Ovary Syndrome (PCOS)
- Thyroid disorders
- Bleeding disorders or use of blood-thinning medications
- Pregnancy-related complications
- Uncommonly, uterine or cervical cancer
Symptoms
- Periods lasting longer than 7 days
- Soaking through pads or tampons every hour for several hours
- Passing large blood clots
- Bleeding between periods or after intercourse
- Any bleeding after menopause
- Fatigue or symptoms of anemia from significant blood loss
Diagnosis
- Detailed menstrual and medical history
- Pelvic examination
- Pelvic ultrasound to check for fibroids, polyps, or structural issues
- Blood tests for hormone levels, thyroid function, and anemia
- Endometrial biopsy or hysteroscopy in select cases
Treatment Options
- Hormonal medications (birth control pills, progesterone therapy) to regulate cycles
- Tranexamic acid to reduce heavy bleeding
- Hormonal IUD for long-term bleeding control
- Treating underlying thyroid or hormonal disorders
- Surgical removal of fibroids or polyps, when present
- Endometrial ablation or, in severe cases, hysterectomy for persistent, unresponsive bleeding
When to See a Doctor
See a gynecologist promptly if you experience unusually heavy or prolonged bleeding, bleeding between periods, or any bleeding after menopause — timely evaluation helps identify the cause and rule out more serious conditions.