Abnormal uterine bleeding can occur at any age but is most common in young girls beginning menstruation or women mid-40s and up in perimenopause.

What is Abnormal Uterine Bleeding?

Bleeding outside of your typical menstrual cycle is generally considered abnormal. This includes:

  • Breakthrough bleeding – bleeding or spotting between periods
  • Menorrhagia – heavy menstrual bleeding categorized by passing blood clots multiple days and soaking through tampons or sanitary pads consistently every hour
  • Irregular periodsyour cycle length varies by 7-9 days. In addition, a cycle longer than 38 days or shorter than 24 days is also considered abnormal

Outside of your menstrual cycle, it is also abnormal to experience bleeding or spotting after sex. Talk to your fertility specialist if you are experiencing any abnormal uterine bleeding.

What Causes Abnormal Uterine Bleeding?

There are many reasons you may experience abnormal uterine bleeding:

  • Endometriosis – the internal lining of your uterus begins to grow outside your uterus
  • Fibroids or polyps – non-cancerous growths of the uterus
  • Ovulation issues – conditions, like polycystic ovarian syndrome (PCOS), that prevent the egg from maturing and releasing
  • Miscarriage – the loss of pregnancy due to death of the baby before 20 weeks
  • Ectopic Pregnancy – when the fertilized egg attaches itself in a place other than the inside of the uterus

Diagnosing Abnormal Uterine Bleeding

The fertility specialist will begin by taking your health and menstrual cycle histories. It’s helpful to track your menstrual cycle for several months prior to your appointment, including the dates, length and type (light, medium, heavy). There will also be a physical exam and tests, as needed. Some of the tests your fertility specialist may recommend include:

  • Pregnancy test
  • Tests to identify sexually transmitted infections (STI)
  • Ultrasound – to view the pelvic organs
  • Hysteroscope – a small scope inserted through the vagina to view inside the uterus
  • Endometrial biopsy – a sample of the endometrium is collected and examined

Treating Abnormal Uterine Bleeding

Your fertility specialist may use medication to treat your irregular menstrual cycle. Prescription medication like Clomid can help regulate your ovulation cycle, improving your chances of becoming pregnant. In conjunction with medication, eating healthfully and properly exercising can improve your menstrual cycle regularity.

If you are experiencing abnormal uterine bleeding, speak with your fertility specialist to learn more about your options.