Abnormal Uterine Bleeding: Causes and Treatments - Obstetrics and Gynecology

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Abnormal uterine bleeding (AUB) is a common concern among women and can arise from various causes, including hormonal imbalances, structural abnormalities, and underlying medical conditions. Understanding the nature of AUB is crucial for effective management and treatment.

From your description, it appears that you have been experiencing irregular menstrual cycles, heavy bleeding, and now have been diagnosed with adenomyosis, which is a condition where the inner lining of the uterus grows into the muscular wall of the uterus. This condition can lead to heavy menstrual bleeding, prolonged periods, and significant pain, especially during menstruation.


Causes of Abnormal Uterine Bleeding
1. Hormonal Imbalances: Fluctuations in estrogen and progesterone levels can lead to irregularities in the menstrual cycle. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can contribute to these imbalances.

2. Structural Abnormalities: Conditions like fibroids, polyps, and adenomyosis can cause heavy and prolonged bleeding. In your case, the diagnosis of adenomyosis is significant as it is known to cause heavy menstrual bleeding and pain.

3. Coagulation Disorders: Some women may have underlying bleeding disorders that can lead to abnormal bleeding patterns.

4. Medications: Certain medications, including anticoagulants and hormonal therapies, can affect bleeding patterns.

5. Infections: Pelvic inflammatory disease (PID) or other infections can also lead to abnormal bleeding.


Treatment Options
Given your recent diagnosis and treatment plan, it is essential to follow your healthcare provider's recommendations. The medications you mentioned, such as "美德能" (likely a form of hormonal therapy) and "強生" (a hemostatic agent), are typically prescribed to manage symptoms associated with AUB and adenomyosis.

1. Hormonal Therapy: Hormonal medications can help regulate your menstrual cycle and reduce the severity of bleeding. They work by stabilizing the endometrial lining and can alleviate symptoms of adenomyosis.

2. Hemostatic Agents: Medications like Tranexamic Acid (which may be similar to "強生") are used to reduce bleeding by promoting clotting. These can be particularly useful during heavy menstrual periods.

3. Monitoring and Follow-Up: It is crucial to have regular follow-ups with your healthcare provider to monitor your condition and adjust treatment as necessary. If you experience significant changes in your bleeding patterns or new symptoms, you should contact your doctor promptly.


Regarding Your Current Medication
Since you mentioned that you started your period after taking the medications, it is generally advisable to continue taking the hormonal therapy as prescribed unless your doctor advises otherwise. Stopping the medication abruptly can lead to a resurgence of symptoms or irregular bleeding. However, if you are concerned about the amount of bleeding or if the bleeding becomes excessively heavy, you should reach out to your healthcare provider for guidance.

In summary, managing abnormal uterine bleeding, especially in the context of adenomyosis, requires a comprehensive approach that includes hormonal treatment, monitoring, and possibly further evaluation if symptoms persist or worsen. Always communicate openly with your healthcare provider about your symptoms and any concerns you may have regarding your treatment plan.