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What is the Abnormal Uterine Bleeding?

Abnormal uterine bleeding is the condition where irregular bleeding from the uterus takes place. The bleeding is heavier or lighter than usual and occurs for a longer duration and is the cause of much distress. It can occur at any time of the monthly cycle of a woman and even occur during the normal menstrual period. However, abnormal uterine bleeding does not occur during pregnancy. Bleeding during pregnancy occurs due to other causes.

One of the symptoms of this disorder is bleeding from the vagina in between periods. Abnormal uterine bleeding can also result in extremely heavy bleeding during the periods. If extreme bleeding occurs for more than 7 days during periods or otherwise, the condition is known as menorrhagia. AUB can occur due to polyps or fibroids, which are irregular growths in the uterus. Some other causes of AUB can include infection in the cervix, a thyroid problem or cancer of the uterus. Another cause of abnormal uterine bleeding is a hormone imbalance. When abnormal bleeding occurs due to hormonal imbalance, the condition is called dysfunctional uterine bleeding. Teenagers and women, who are approaching menopause, are more susceptible to dysfunctional uterine bleeding.

The treatment for abnormal uterine bleeding depends on age, the cause of the bleeding and whether the person wants to get pregnant in the future or not. However, the different treatment options include the use of an intrauterine device, birth control pills, D&C or dilatation and curettage, endometrial ablation and hysterectomy.

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How is the treatment done?

IUD or intrauterine device is a small, plastic device that is inserted into the uterus through the vagina of a woman getting treated. The IUD releases hormones that help to reduce abnormal bleeding. Another way to prevent abnormal bleeding is by using birth control pills. They prevent the lining of the uterus from getting too thick and also help to regularize the menstrual cycle and even reduces cramping.

Another effective method of treating abnormal uterine bleeding is the D&C or dilatation and curettage procedure. In this method, the opening of the cervix is stretched so that a surgical tool can be inserted into the uterus. The lining of the uterus is scraped away with the help of this tool. The doctor then checks the removed lining for any abnormality and to determine the cause of the abnormal bleeding. D&C is performed to find out the cause of bleeding and also to address it in patients who suffer from heavy bleeding from the uterus.

Hysterectomy is a surgical procedure whereby the uterus is removed. It does not allow the patient to have any more periods and does not allow her to get pregnant. It is normally performed under general anesthesia and requires a person to stay at a hospital.

Endometrial ablation does not remove the uterus but destroys the lining of the uterus. All types of menstrual bleeding are halted as a result of the procedure.

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How is the treatment done?

IUD or intrauterine device is a small, plastic device that is inserted into the uterus through the vagina of a woman getting treated. The IUD releases hormones that help to reduce abnormal bleeding. Another way to prevent abnormal bleeding is by using birth control pills. They prevent the lining of the uterus from getting too thick and also help to regularize the menstrual cycle and even reduces cramping.

Another effective method of treating abnormal uterine bleeding is the D&C or dilatation and curettage procedure. In this method, the opening of the cervix is stretched so that a surgical tool can be inserted into the uterus. The lining of the uterus is scraped away with the help of this tool. The doctor then checks the removed lining for any abnormality and to determine the cause of the abnormal bleeding. D&C is performed to find out the cause of bleeding and also to address it in patients who suffer from heavy bleeding from the uterus.

Hysterectomy is a surgical procedure whereby the uterus is removed. It does not allow the patient to have any more periods and does not allow her to get pregnant. It is normally performed under general anesthesia and requires a person to stay at a hospital.

Endometrial ablation does not remove the uterus but destroys the lining of the uterus. All types of menstrual bleeding are halted as a result of the procedure.

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Who is eligible for the treatment?

A person is eligible for treatment if she experiences some or all of the symptoms associated with abnormal uterine bleeding. Some of the symptoms are spotting or bleeding from the vagina between periods, frequent or irregular periods, and heavier bleeding due to large clots. A person may suffer from AUB if the bleeding lasts for more than seven days or for a period longer than what is normal. AUB may also occur due to hormonal imbalance. The symptoms associated with hormonal imbalance include excessive growth of body hair, mood swings, hot flashes and dryness and tenderness of the vagina.

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Who is not eligible for the treatment?

A person is eligible for surgical procedures only if she is suffering from a serious condition and if she has not experienced any tangible benefits from medications. However, a person will only be eligible for treatment if she experiences some or all of the symptoms associated with AUB and has been properly diagnosed by a doctor.

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Are there any side effects?

The side-effects associated with dilation and curettage treatment are foul-smelling discharge from the vagina, abdominal pain, heavy bleeding and fever accompanied with chills. A person undergoing hysterectomy may experience a number of side-effects including clotting of blood in the legs or lungs, heavy bleeding, infection, injury to the organs that are located nearby and she may also experience pain during sexual intercourse. Endometrial ablation entails a frequent urge for urination in the first 24 hours, menstrual cramps for a couple of days, discharge of a thin, watery fluid mixed with blood and feeling of nausea.

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What are the post-treatment guidelines?

A woman will generally recover from the effects of endometrial ablation within a week or so. However, a doctor might advise her to refrain from any strenuous activities and also lifting any weights. She will also stop having sex and using sanitary napkins for the time being. A person requires at least 4-6 weeks to recover from hysterectomy. In this case too, a person is advised not to indulge in any strenuous activities and not to lift any weights. Any type of treatment undertaken for abnormal uterine bleeding requires a regular follow-up with the doctor and adherence to the guidelines that are recommended.

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How long does it take to recover?

It takes about 4-6 weeks for a woman to resume with her normal activities after hysterectomy. A person undergoing endometrial ablation will take a week to recover. A person will take some time to recover if she has undergone the dilation and curettage treatment. The doctor may advise her to avoid having sex, or not to use douche or tampons.

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Are the results of the treatment permanent?

Hysterectomy and endometrial ablation are surgical procedures that require the complete or partial removal of the uterus. These treatments may prove to be a permanent solution for abnormal uterine bleeding problem. However, the dilation and curettage treatment may not always provide permanent results. The bleeding may start again if there is any problem in the uterus. Birth control pills are used to prevent the wall of the uterus from getting heavy. However, this is not a permanent solution as the bleeding might resume once a patient is off the pills.

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What are the alternatives to the treatment?

A person suffering from abnormal uterine bleeding should incorporate foods like whole grains, fresh ripe fruits and fresh vegetables and fish like sardines and tuna so that her body receives the required nourishment. Adequate intake of foods rich in iron is required to deal with this condition. Ginger has well-known healing properties and helps to deal with the excessive bleeding from the uterus. Furthermore, hemostat agent therapy can be used to treat people suffering from dysfunctional uterine bleeding.

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Key Highlights

Safety: Medium

Effectiveness: Medium

Timeliness: Medium

Relative Risk: Medium

Side Effects: High

Time For Recovery: Medium

Price Range: Tk. 10,000 to Tk. 3,50,000

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