Abnormal Menstrual Bleeding
“Abnormal menstrual bleeding” refers to deviations from the normal menstrual pattern; that is, it includes unusual bleeding in terms of duration, amount, or frequency. This condition, commonly encountered during women’s reproductive years, can be due to both hormonal and structural reasons. Normally, menstrual bleeding occurs every 21–35 days, lasts 3–7 days, and results in a total blood loss of about 30–80 mL. Any situation outside these limits is defined as “abnormal uterine bleeding.” Abnormal bleeding may not only indicate a problem related to the uterus but can also be a sign of hormonal imbalances.
What is Abnormal Menstrual Bleeding?
Abnormal menstrual bleeding (Abnormal Uterine Bleeding – AUB) refers to deviations from the normal in terms of amount, duration, or frequency in the menstrual cycle. Bleeding can be excessive (menorrhagia), occur at very frequent intervals (polymenorrhea), or be irregular (metrorrhagia). In some patients, prolonged absence of menstruation (amenorrhea) or intermenstrual bleeding may also accompany the condition. These situations are generally associated with hormonal imbalances, intrauterine pathologies (fibroids, polyps, endometrial thickening), or ovulation problems.
How Does Abnormal Menstrual Bleeding Occur?
The menstrual cycle is regulated by hormonal communication between the brain, ovaries, and uterus. When ovulation (ovulation) does not occur, the hormone progesterone is not sufficiently secreted, and the uterine lining sheds irregularly; this leads to prolonged and heavy bleeding. Additionally, low levels of Anti-Müllerian Hormone (AMH) in cases of Diminished Ovarian Reserve (DOR) or hormonal disorders can affect the menstrual cycle. Excess estrogen, uterine thickening, thyroid disorders, or polycystic ovary syndrome (PCOS) are also common causes.
Causes of Abnormal Menstrual Bleeding
Structural and functional causes are examined in two main groups. Structural causes include fibroids, endometrial polyps, intrauterine adhesions, or adenomyosis. Functional causes are hormonal imbalances, ovulation disorders, and systemic diseases. Bleeding disorders (e.g., coagulation problems), thyroid diseases, or certain medications can also be effective. In some cases, no clear cause can be found, and it is termed “dysfunctional uterine bleeding.”
Symptoms of Abnormal Menstrual Bleeding
Increased bleeding amount, intermenstrual bleeding, prolonged periods, shortening of intervals between periods, or becoming completely irregular are the most common symptoms. Some women may experience anemia, weakness, dizziness, and fatigue. Bleeding may be clotted or painful. Therefore, noticeable changes in menstrual patterns require gynecological evaluation.
Diagnosis of Abnormal Menstrual Bleeding
For diagnosis, a detailed gynecological examination and ultrasound evaluation are first performed. The structure of the uterus and ovaries is examined; if necessary, the inside of the uterus can be directly visualized with hysteroscopy. Hormone tests (FSH, LH, estrogen, progesterone, AMH, thyroid hormones, etc.) reveal factors affecting the menstrual pattern. In some cases, a biopsy from the uterine lining is taken to investigate endometrial pathologies.
Treatment of Abnormal Menstrual Bleeding
Treatment is planned according to the underlying cause. In cases related to ovulation disorders, ovulation therapy or hormonal regulators (progesterone, birth control pills, IUD, etc.) may be used. In structural causes such as fibroids or polyps, hysteroscopic or laparoscopic surgery may be applied. If there is diminished ovarian reserve (DOR) or hormonal insufficiency, an appropriate treatment plan is made to restore the menstrual pattern. The aim of the treatment is to reduce the amount of bleeding and to preserve fertility capacity.
Lifestyle and Supportive Approaches in Abnormal Menstrual Bleeding
Regular sleep, balanced nutrition, and stress control help maintain hormonal balance. Excessive weight gain or rapid weight loss can negatively affect the menstrual pattern. If iron deficiency has developed, supplementation may be necessary. Yoga, light exercise, and stress-reducing activities also contribute to a more regular menstrual cycle.
When to Consult a Doctor?
If menstrual bleeding becomes very heavy, clotted, or painful; if the interval between periods is shorter than 21 days or lasts longer than 7 days; if intermenstrual bleeding or postmenopausal bleeding occurs, a gynecological evaluation should be conducted. Especially in women over 40, irregular bleeding should definitely be investigated.
| Condition | Definition |
|---|---|
| Menorrhagia | Prolonged or excessive menstrual bleeding |
| Polymenorrhea | Periods occurring at intervals shorter than 21 days |
| Metrorrhagia | Irregular intermenstrual bleeding |
| Amenorrhea | Absence of menstrual bleeding for 3 months or longer |
| Dysfunctional Bleeding | Irregular uterine bleeding due to ovulation disorder |
Prices for Abnormal Menstrual Bleeding
The diagnosis and treatment process may vary depending on the tests performed (ultrasound, hormone tests, biopsy, etc.), treatment method, and surgical requirements. In our clinic, an individual evaluation is conducted for each patient to create an appropriate treatment plan. For current price information, please contact our clinic. 4de
In conclusion, abnormal menstrual bleeding may not always be a simple irregularity; sometimes it is a sign of an underlying hormonal or structural problem. With early evaluation and appropriate treatment, both menstrual regularity and overall reproductive health can be preserved. 338
Frequently Asked Questions About Abnormal Menstrual Bleeding
Question: Why might my menstrual bleeding be excessive?
The uterine lining may have thickened due to causes such as fibroids, polyps, or ovulation disorders. A detailed examination is required.
Question: Does low AMH cause menstrual irregularity?
Yes. Low AMH level (DOR) means a decrease in ovarian reserve and menstrual intervals may lengthen or become irregular.
Question: What tests are performed in abnormal bleeding?
Hormone tests (FSH, LH, estrogen, progesterone, AMH, thyroid), ultrasound, and if necessary, uterine biopsy are applied.
Question: What happens if abnormal menstrual bleeding is not treated?
If not treated, anemia, ovulation disorders, and uterine diseases may develop in the long term.
