When is menstrual bleeding abnormal?

Menstrual bleeding is abnormal when is occurs more often than every 3 weeks, less often than every three months, occurs completely unpredictably, occurs after the menopause, or before age 9.

Menstrual flow is considered excessive when it lasts more than 7 days, occurs more often than every 3 weeks, is making you anemic, is causing you to lose work, or is otherwise affecting your lifestyle. Signs that menstrual bleeding may be excessive include passing clots, needing to change pads at night, saturating a regular pad or tampon more often than every hour for more than 3 hours in a row, being afraid to leave home because of fear of an "accident", staining clothes, flooding sheets, needing to be on iron to maintain your hemoglobin in a normal range.

What causes abnormal bleeding?

There are many causes of abnormal bleeding.
(1) ANOVULATORY CYCLES: Frequent or excessive periods may be caused by an excessive of estrogen relative to progesterone, usually because of an anovulatory cycle (ie a cycle in which ovulation does not occur).

(2) POLYPS: Sometimes there is a polyp, or polyps within the uterus (these are outpouchings of the lining of the uterus, usually benign).

(3) FIBROIDS: Sometimes there are benign smooth muscle tumors called fibroids, or leiomyomas, within the muscle wall of the uterus. These can increase the surface area inside the uterus that sheds every month and cause bleeding to be excessive. They can also make it difficult for the uterus to contract properly to stop or slow down menstrual flow.

(4) THYROID PROBLEMS: From time to time, thyroid problems can cause changes in frequency and duration of menstrual flow. Other signs of thyroid problems may include unexplained weight changes, changes in hair or skin texture, heat or cold intolerance.

(5) MEDICATIONS: Hormones such as oral conraceptives are often used to treat abnormal uterine bleeding, but are sometimes the cause.

(6) CHRONIC INFECTION: Chronic infection or inflammation of the uterus is known as "chronic endometritis" and is usually caused by bacteria tracking their way from the vagina through the cervix to the uterus.

(7) PRECANCERS INSIDE THE UTERUS: Endometrial hyperplasia, with or without atypical cells, is a precancerous condition of the endometrial lining of the uterus caused by exposure to too much estrogen and not enough progesterone. This usually occurs in people who are having irregular cycles, or whose periods are less frequent than every 3 months. It is more common in women who are overweight, have diabetes, or a family history or diabetes.

What tests are usually done to determine the cause of abnormal uterine bleeding?

How is abnormal uterine bleeding treated?