Abnormal Uterine Bleeding

If menstrual periods are so heavy that they affect normal activities, women may have excessive menstrual bleeding ( abnormal uterine bleeding). The medical term for periods that are very heavy, last longer than normal or both is menorrhagia. Symptoms may also include cramping, pelvic pain and anemia.

Depending on the cause, the size of the uterus, and other factors, multiple treatment options are available. Many women may perceive menses as normal despite the fact that they have excessive menstrual bleeding which frequently may result in iron deficiency anemia. Irregular and heavy bleeding encountered by women in reproductive age require a thorough and individualized management since many different factors may account for it. In addition to conservative management such hormonal treatment, surgical options are available including endometrial ablation, hysteroscopic resection of polyps or fibroids, robotic removal of uterine fibroids or removal of the uterus with preservation of ovaries. 




Causes of Abnormal Uterine Bleeding


Non-hormonal Causes :

  • Fibroids – benign (non-cancerous) growths in or near the uterus
  • Polyps – growths that attach to the inner wall of the uterus and protrude into the uterine cavity
  • Adenomyosis – endometrial tissue normally lining the uterus grows into the muscular walls of the uterus
  • Endometriosis– tissue that normally lines the inside of your uterus grows outside your uterus
  • Endometrial cancer – an uncontrolled growth of cells of the uterine lining
  • Hyperplasia – an abnormal proliferation of cells  that may result in enlargement (growth) of the uterus. This term is sometimes used to refer to a benign tumor or fibroid.

Hormonal Causes: 

  • Polycystic ovary syndrome- (PCOS) is a common hormonal disorder among women of reproductive age. Women with the disorder have enlarged ovaries containing numerous small cysts located along the outer edge of each ovary (polycystic appearance), are usually overweight and have infrequent menses.
  • Hypothyroidism- under-function of the thyroid gland
  • Hyperthyroidism-increased hormonal production of thyroid hormones 
  • Perimenopause- a time before menopause which may start 6 years before the actual menopause

Treatment options:


To obtain hemostasis (bleeding control) in gynecological surgeries for uterine bleeding and other indications, various hemostatic agents are used. Dr. Wolny presented a scientific abstract on hemostatic agents at an annual meeting of American Association of Gynecologic Laparoscopists which is shown below.



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