Abnormal uterine bleeding is a condition in which women have heavy bleeding during their menstrual cycles, bleeding between their periods, bleeding after intercourse, frequent periods within 21 days and continuous not cyclical bleeding, and also irregular periods.
AUB is defined as bleeding which may be accompanied by pain and discomfort, causing significant social embarrassment, and have a substantial effect on health-related quality of life. This can affect women of all ages, right from puberty to menopause.
A normal menstrual cycle is defined as five to eight days of bleeding every 28 to 30 days.
Causes of Abnormal Uterine Bleeding
The most common causes are Hormonal imbalance, Pelvic infections, Fibroid uterus, adenomyosis, endometriosis, polyp in the uterus, cancer-related to the uterine lining or the uterine cervix, use of any external medications, and bleeding disorders. Along with them, certain associated patient factors increase the bleeding pattern like Obesity, Diabetes, Thyroid problems, and use of any medications.
Treatment Measures
A thorough history of the person is required before proceeding with treatment. Initially, we have to understand the scenario based on the patient's explanation regarding their normal periods and current cycle patterns. Associated medical conditions will be enquired and how it affects their personal and social life. Effects of severe blood loss like easy fatigue, difficulty in breathing, and walking small distances.After this needs a complete physical examination and internal examination under the supervision of the best gynecologist in Mysore.
Investigations
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Blood tests to check for anemia(low hemoglobin), diabetes, thyroid, and hormonal profile in Pcod.
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Ultrasound of the female organs to check for the thickness of the lining of the uterus, fibroids, ovarian cysts, and any polyps will be done. Some time may need an internal ultrasound called TVS(transvaginal scan )to detect the anatomy of the uterus and ovaries more accurately.
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Hysteroscopy is an examination of the inside of the uterus to detect polyps or cancer of the endometrium.
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Sometimes an MRI may also be advised if suspecting fibroids or adenomyosis and cancer of the uterus.
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Biopsy of the lining of the uterus to check for tissue diagnosis.
Treatment Options
Abnormal uterine bleeding treatment procedure depends on several factors. The main concern of the patient is addressed.Anemia correction may include treatment with multivitamins and iron tablets or injections, but in severe cases may need a blood transfusion. Cause of blood loss in form of hormonal imbalance can be treated with oral hormonal preparations and medicine to reduced bleeding.The medicine can be taken only during periods ,or oral daily or combined pills for 21 days.Similar medications can be given in injection forms also. Also, intrauterine hormonal devices are available and effective in treating abnormal uterine bleeding.These hormonal devices are safe and effective. Incase of uterine polyps can be treated by hysteroscopic surgery.In case of huge fibroids or adenomyosis and cancer, if completed family, a patient will be offered vaginal, abdominal, or laproscopic hysterectomy depending upon their options and choices.
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