AUB is the fourth most common symptom that leads a woman to seek gynecological advice. From a healthcare point of view, it is also associated with high direct and indirect costs. Symptoms of AUB frequently co-exist with fibroids. The relationship between them, however, is not totally understood. In many women, fibroids may be an incidental innocent bystander in the underlying causes of a menstrual bleeding complaint.1

In some circumstances, AUB may even mask a (pre)cancerous uterine condition and therefore always justifies a detailed evaluation.2

What are the symptoms of AUB?

The following definitions describe menstrual patterns associated with AUB:

  • Oligomenorrhea: Cycle length greater than 35 days
  • Polymenorrhea: Cycle length less than 21 days
  • Menorrhagia: Heavier and increased menstrual bleeding
  • Metrorrhagia: Irregular episodes of bleeding occurring outside of menses
  • Menometrorrhagia: Longer duration of flow occurring at unpredictable intervals
  • Postmenopausal bleeding: Bleeding that occurs more than 12 months after the last menstrual cycle
  • DUB (Dysfunctional Uterine Bleeding): Erratic or irregular bleeding not associated with intrauterine pathology3

If you are experiencing any of these symptoms, don’t let them takeover your quality of life. Put your mind at rest and make time to consult your doctor or healthcare specialist.

What Happens Next?

You may be asked to undergo some tests to find out the definitive cause of these symptoms, which may be related to various gynecological conditions.

These tests include:

  • An endocrine blood profile (To measure the levels of various hormones and to learn if the endocrine glands are working correctly.
  • An intrauterine endoscopy called hysteroscopy (the doctor looks at the inside of the womb using a hysteroscope; a narrow tube with a telescope at the end)
  • An ultrasound or MRI scan of the uterus and ovaries
  • Dilation and curettage (D&C) is a procedure in which the cervix is dilated and a special instrument is used to to remove tissue from inside the uterus. 

How is AUB treated?

Treatment is individual to each woman, and may vary from hormonal medical management such as prescribing oral contraceptives to surgery. For every patient, the treatment must aim at restoring or improving her quality of life.2

Surgical treatment is sometimes an option depending upon severity of symptoms, lack of response to other medical management and the medical condition of the woman. This may be either a conservative (hysteroresectoscopy) or radical (hysterectomy).4

  • 1. Clark TJ, Middleton LJ, Cooper NAM, et al. A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding. Health Technology Assessment, No. 19.61. NIHR Journals Library; 2015 Jul.

  • 2. L Whitaker et. Al. Abnormal uterine bleeding, Best Practice & Research Clinical Obstetrics & Gynaecology Volume 34, July 2016, Pages 54-65

  • 3. L.Bradley Abnormal Uterine Bleeding. https://www.sciencedirect.com/science?_ob=PdfExcerptURL&_imagekey=3-s2.0-B9780323032476100140-main.pdf&_piikey=B9780323032476100140&_cdi=278453&_orig=article&_zone=centerpane&_fmt=abst&_eid=3-s2.0-B9780323032476100140&_user=3730613&md5=c3305c3735583a5a8a244a3c7a88d83f&ie=/excerpt.pdf

  • 4. The American College of Obstetricians and Gynecologists, Women’s Healthcare Physicians, April 2013, Committee on Gynecologic Practice, Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women