The inside of the uterus has two layers. The thin inner layer is called the endometrium. The thick outer layer is the myometrium (myo = muscle).
In women who menstruate, the endometrium thickens every month in preparation for pregnancy.
If the woman does not become pregnant, the endometrial lining is shed throughout the menstrual period. After menopause, the lining normally stops growing and shedding.
Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period (less than 5 tablespoons or 80 mL).
Bleeding that occurs sandwiched between menstrual periods or excessive menstrual bleeding is considered to be uncharacteristic uterine bleeding.
Causes of Uterine Bleeding
Hormonal imbalances that interfere with ovulation can result in abnormal uterine bleeding.
A number of things can interfere with the intricate hormonal balance that affects ovulation and bleeding.
1. Pregnancy. In women of childbearing age, pregnancy is the leading cause of skipped periods.
2. Perimenopause. The hormonal changes that occur during the years foremost up to menopause (the cessation of menstruation) can cause bleeding abnormalities.
3. Stress. Stress hormones such as cortisol are known to interfere with ovulation.
4. Polycystic ovary syndrome (PCOS). PCOS is a condition in which the ovaries become filled with tiny cysts and enlarge.
The problem occurs when the pituitary gland produce too much of a hormone called luteinizing hormone (LH).
Symptoms of Uterine Bleeding
1. Vaginal bleeding that occur more often than every 21 days or farther apart than 35 days (a normal teen menstrual cycle can last up to 45 days).
2. Vaginal bleeding that lasts longer than 7 days (normally lasts 4 to 6 days).
3. Blood loss of more than 80 mL (2.7 fl oz) each menstrual cycle [normally about 30 mL (1 fl oz)]. If you are passing blood clots and soaking during your usual pads or tampons each hour for 2 or more hours, your bleeding is careful severe.
Treatment of Uterine Bleeding
Make sure that the bleeding is coming from the vagina and is not from the rectum or in the urine.
You can insert a tampon into your vagina to confirm that the source of your bleeding is impending from the area of your vagina, cervix, and uterus.
If your bleeding is heavy, rest in bed.
Keep track of the number of pads or tampons you use so that you and your health care practioner can decide the amount of your bleeding.
Birth Control Pills
Birth control pills contain hormones that can stop the lining of your uterus from getting too thick. They can also help keep your menstrual cycle regular and reduce cramping.
Combination birth control pills are a common treatment for DUB. They contain the hormones estrogen and progestin, and are taken daily.
Combination pills slightly augment the risk of heart disease, high blood pressure and blood clots.
If you smoke or have a medical history of any of these circumstances, your doctor may prescribe a progestin-only pill (also called the mini-pill).
Progestin-only pills can cause side belongings counting breast tenderness, bloating, headaches, mood swings and spot (light vaginal bleeding between periods).
You should tell your doctor if any side effects become a problem for you.
Surgery
If you don’t want to get pregnant in the future, and if birth control pills or the IUD don’t work, 2 surgical options are available to treat DUB: hysterectomy and endometrial ablation.
Hysterectomy is surgery that removes the uterus. If you have a hysterectomy, you won’t have any more period and you won’t be able to get pregnant.
Hysterectomy is major surgery that requires general anesthesia (puts you in a sleep-like state) and a hospital stay.
It may require a long recovery period. Talk to your doctor about the risks and benefits of hysterectomy.
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