Abnormal Uterine Bleeding: Causes and Treatments Explained

Abnormal bleeding

Hello doctor, my menstrual cycle is regular, occurring every 28 days.
My last menstrual period started on April 10, but on April 23, I experienced dark red discharge.
The doctor diagnosed me with hormonal imbalance and noted a small cyst on my ovary, which is expected to resolve on its own, and medication would help improve the situation.
My last menstrual period started on May 31, but on June 10, I experienced bright red bleeding with a heavy flow, without abdominal pain.
The doctor prescribed a three-day course of hemostatic medication, and the bleeding stopped after taking it.
However, on June 16, I had bleeding again, and I am unsure about the cause of this phenomenon.
Thank you, doctor.

Ting Yi, 30~39 year old female. Ask Date: 2001/06/16

Dr. Zhan Deqin reply Obstetrics and Gynecology

1.
Menstruation started on April 10, and on April 23, there was dark red bleeding, which could possibly be ovulation bleeding.
2.
Sometimes, if the cause of the bleeding cannot be identified, it is referred to as dysfunctional uterine bleeding.
Generally, it is not a major concern, but it is advisable to perform a Pap smear and ultrasound to ensure there are no issues.
3.
If it is really bothersome, you can consider regulating your menstrual cycle for a few months, which should help improve the situation.
If there are still concerns, please visit a gynecology clinic.

Reply Date: 2001/06/16

More Info

Abnormal uterine bleeding (AUB) is a common issue that can significantly impact a woman's quality of life. Understanding its causes and treatments is essential for effective management. Based on your description, it appears that you have been experiencing irregular bleeding between your menstrual cycles, which has been diagnosed as a result of hormonal imbalance and possibly the presence of an ovarian cyst.

Causes of Abnormal Uterine Bleeding
1. Hormonal Imbalance: The menstrual cycle is regulated by hormones, primarily estrogen and progesterone. Any disruption in the balance of these hormones can lead to irregular bleeding. For instance, if ovulation does not occur, the body may not produce enough progesterone, leading to an unstable endometrial lining that can shed irregularly.

2. Ovarian Cysts: The presence of ovarian cysts, particularly functional cysts, can also contribute to abnormal bleeding. These cysts can produce hormones that disrupt the normal menstrual cycle, leading to unexpected bleeding.

3. Uterine Conditions: Conditions such as fibroids, polyps, or endometrial hyperplasia can cause abnormal bleeding. While you mentioned that your doctors have ruled out significant structural issues, it's important to keep these in mind as potential causes.

4. Medications: Certain medications, including hormonal contraceptives and anticoagulants, can lead to changes in bleeding patterns. If you are on any medications, it’s crucial to discuss their potential side effects with your healthcare provider.

5. Stress and Lifestyle Factors: High levels of stress, significant weight changes, or changes in physical activity can also affect hormonal balance and lead to irregular bleeding.

Treatment Options
1. Hormonal Therapy: Since your bleeding has been attributed to hormonal imbalance, your doctor may recommend hormonal treatments. This could include birth control pills, which help regulate the menstrual cycle and stabilize hormone levels.
2. Medications for Bleeding Control: Tranexamic acid, which you mentioned, is often prescribed to help control heavy bleeding. It works by reducing the breakdown of blood clots, thus helping to manage excessive menstrual bleeding.

3. Monitoring and Follow-Up: Regular follow-up appointments are essential to monitor your symptoms and adjust treatment as necessary. If the bleeding persists or worsens, further evaluation may be required, including imaging studies or endometrial biopsy.

4. Lifestyle Modifications: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and stress management techniques, can also help regulate your menstrual cycle.

5. Alternative Therapies: Some women find relief through alternative therapies, such as acupuncture or herbal supplements. However, it’s important to discuss these options with your healthcare provider to ensure they are safe and appropriate for your situation.

Conclusion
In conclusion, abnormal uterine bleeding can stem from various causes, primarily hormonal imbalances and ovarian cysts in your case. Treatment typically focuses on regulating the menstrual cycle and managing symptoms. It’s crucial to maintain open communication with your healthcare provider, report any changes in your symptoms, and adhere to follow-up appointments for ongoing evaluation. If your symptoms persist or you experience new symptoms, further investigation may be warranted to rule out other underlying conditions. Remember, you are not alone in this, and with the right approach, many women find effective management strategies for their symptoms.

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