Abnormal uterine bleeding: What to watch out for

The article is professionally consulted by Master, Doctor Nguyen Van Thanh - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Ha Long International General Hospital.

In most cases, abnormal uterine bleeding is a sign of a medical condition. Therefore, when women notice vaginal bleeding, it is necessary to go to the doctor immediately to be diagnosed, tested and treated promptly by a gynecologist.
Uterine bleeding in women usually only occurs during menstruation. However, it is possible that because of some gynecological disorder, the bleeding becomes unusual compared to usual. So what kind of uterine bleeding is called abnormal?

When vaginal bleeding is noticed in any of the following situations, it is considered abnormal uterine bleeding:
Bleeding or spotting of blood before menstruation or after sex Irregular heavy bleeding during menstruation Menstrual cycle is longer than 38 days or shorter than 24 days Menstrual disorders occur frequently over a long period in which the menstrual cycle length is more than 7 days Uterine bleeding post-menopause

In fact, this phenomenon can occur at any age. However, at certain points in a woman's life, the odds of abnormal uterine bleeding are lower.
Specifically, menstrual disorders leading to uterine bleeding are less common in girls who have just entered puberty (about 9-14 years old). During perimenopause (usually beyond the age of 40), the interval between periods will be longer. Some perimenopausal women may experience missed periods, more or less bleeding. This is completely normal.

Some causes of abnormal uterine bleeding include:
Ovulation problems Uterine fibroids and polyps Blood clotting problems Problems related to some birth control methods, such such as using a birth control device or side effects of birth control pills Miscarriage Ectopic pregnancy Cancer, like uterine cancer. When detecting signs of abnormal uterine bleeding, women should immediately go to a medical facility for examination. Your obstetrician and gynecologist will make a diagnosis and check your chances of getting the disease according to your age. Most disorders are easy to spot, aren't serious, and can be treated right away. Others may be more serious and require tests for an accurate diagnosis.

During the medical examination, the doctor will mention your medical history and menstrual cycle. Some women can't remember exactly what their menstrual cycle is like this month compared to previous months. This causes many difficulties in the examination and diagnosis of abnormal uterine bleeding of the patient.
Therefore, women should monitor and record important information about their menstrual cycle from before. Take note of information such as the date of onset, length of your period, and the amount of bleeding (many, moderate, light or spotty). You can also use smartphone apps designed specifically for menstrual cycle tracking.
Your doctor may ask you to perform a range of motion exercises for a physical exam. You may have blood tests to check your blood parameters and hormone levels to rule out blood diseases. In addition, when there are signs of doubt, your doctor will order a pregnancy test or diagnostic test for sexually transmitted diseases. These are common causes of abnormal vaginal bleeding.

Based on your medical history, clinical symptoms, and age, your doctor may need to perform other necessary tests:
Ultrasound: Uses sound waves to create images of the muscles. pelvic organs. Hysteroscopy: A procedure that inserts a light into the vagina, past the cervix, and helps the doctor see inside the uterus. Endometrial biopsy: A sample of the endometrium is removed and examined under a microscope. Endoscopic ultrasound: Endoscopic examination with the help of ultrasound waves. Nuclear magnetic resonance imaging (MRI): Creates anatomical images of an organ system using magnetic fields and radio waves. Computed tomography (CT): Uses X-rays to create cross-sectional images of organs and internal structures.

The process of treating vaginal bleeding requires the cooperation of the patient. Usually, the doctor will explain the cause of the disease and instruct the patient what to do when there is vaginal bleeding. Next, the doctor will prescribe a suitable treatment:
6.1. Drug use After determining the cause of uterine bleeding, most patients will be prescribed medication. What medicine to take, when and in what dose depends on the treating doctor. The treatment drugs used may include the following effects:
Hormonal birth control, menstrual cycle regulation. Stop the menstrual cycle and reduce the size of uterine fibroids. Treatment of severe vaginal bleeding. Anti-inflammatory, control bleeding, relieve menstrual pain. Treat infection if present. If you have a bleeding disorder, medications that help with blood clotting may be included. 6.2. Surgery or procedure In cases where medication cannot solve the problem, the patient may need surgery or a procedure. Your choice of surgery or procedure depends on your bleeding, your age, and your decision about whether or not you want to have more children. Surgical methods and procedures are used to treat abnormal uterine bleeding:
Aspiration or curettage: Helps stop bleeding or significantly reduces it. Uterine artery embolization: Used to treat uterine fibroids. This surgery helps to block blood vessels to the uterus, thereby limiting blood supply to the fibroid. Another treatment that doesn't affect the uterus is surgical removal of the fibroids. Hysterectomy: Used when other treatments have failed. Hysterectomy is also surgery to treat endometrial cancer. After the uterus is removed, the woman will no longer be able to menstruate, nor will she be able to get pregnant. Women who are diagnosed with the disease should not be too worried, but should not be subjective with their condition. See your doctor as soon as possible for an early diagnosis and prompt treatment.

At Vinmec International General Hospital, we are currently implementing the BASIC Gynecological Examination and Screening Package, helping customers detect inflammatory diseases early, so that the treatment process will be easy and inexpensive. . It is also possible to screen for early gynecological cancer (cervical cancer) even if there are no symptoms.
Doctor Nguyen Van Thanh has many years of experience in Obstetrics and Gynecology. The doctor was trained and attended courses in obstetrics and gynecology and infertility at Hai Phong University of Medicine and Pharmacy, Hanoi University of Medicine and Pharmacy and the National Hospital of Obstetrics and Gynecology.

Article referenced source: Acog.org