Abnormal Uterine Bleeding: Diagnosis & Treatment

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This article on Abnormal Uterine Bleeding was written with the help of the speakers based off the popular topics from our recent educational webinar “Women’s Health & Self-Care” jointly organised with Singapore Nurses Association in conjunction with Nurses’ Day.

Read on to learn more about Abnormal Uterine Bleeding.

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Abnormal uterine bleeding can be caused by many different factors. Hence, it is crucial to identify the exact cause through a series of diagnostic steps so that the most optimal medical treatment can be prescribed.

Identifying the causes of Abnormal Uterine Bleeding

It is important to determine the diagnosis of Abnormal Uterine Bleeding to choose the most appropriate management for an individual patient. This can be accomplished by:

• Obtaining a full medical record¹

  • To record details of current bleeding episodes, related symptoms and past medical history

• Performing a physical examination¹

  • To evaluate overall health

  • Pelvic examination to assess for any mass, size and shape of the uterus, discharge or tenderness which may suggest infection

• Conducting various tests¹

  • Pregnancy test : To exclude pregnancy causation

  • Blood test : To assess for any anemia, clotting disorders or hormonal imbalance disease

  • Pelvic ultrasound : To evaluate endometrium thickness and any structural causes

  • Swab test : To assess for presence of any infection or cervical pathology

  • Endometrial biopsy : To rule out endometrial hyperplasia and cancer

What can you do if you have abnormal uterine bleeding?

Numerous factors are taken into consideration when deciding a personalized treatment approach. Medical therapy is considered the preferred initial treatment. However, medications may have side effects and contraindications which are usually required to be discussed with a healthcare professional before starting treatment.

Options of medical therapy include:²

• Non-hormonal

  • Non-steroidal anti-inflammatory drugs (NSAIDs), anti-fibrinolytic agents

• Hormonal medications

  • Progestin-only therapy, estrogen-progestin therapy

Not every case of abnormal uterine bleeding can be treated by the same surgery. For example, both endometrial ablation and uterine artery embolization are not suitable in pregnancy, active infections, or uterine malignancy cases.

Aside from medications, surgery may be necessary to remove abnormal structures such as fibroids or polyps. There are different types of surgical procedures that can be done depending on various factors such as diagnosis and medical history.

The types of surgical procedures are:²

• Polypectomy or Myomectomy

  • For removing polyps or fibroids respectively

• Endometrial Ablation

  • For those unsuitable for medical therapy to treat heavy menstrual bleeding

• Uterine Artery Embolisation (UAE)

  • For treating fibroids by reducing blood supply to the fibroids

• Hysterectomy

  • Definitive surgery by removal of the entire uterus but will cause permanent infertility

Conclusion

• Abnormal uterine bleeding is a common and debilitating condition.

• There are multiple factors that may lead to abnormal uterine bleeding.

• It is important to have an accurate diagnosis to determine optimal treatment.

• Treatment should be individualized with considerations of the impact of clinical symptoms, desire for maintaining fertility, and underlying risk factors in order to achieve improved quality of life.

This health article is brought to you by Miraco Nutripharm. With clinically proven women’s probiotic Pro-Uro™ as our key product, we believe in sharing about common health topics relevant to women. Look out for our next article on Ovarian Cysts.

Reference

1. De Silva NK. Abnormal uterine bleeding in adolescents: Evaluation and approach to diagnosis. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA, 2021.

2. Whitaker L, Critchley HO. Abnormal uterine bleeding. Best Pract Res Clin Obstet Gynaecol. 2016;34:54-65. doi:10.1016/j.bpobgyn.2015.11.012

Disclaimer: The article content is intended for informational or educational purposes only, and does not substitute professional medical advice or consultations with healthcare professionals. The disclaimer also provides that no warranties are given in relation to the medical information supplied in the article, and that no liability will accrue to Miraco Nutripharm Pte Ltd or any affiliated authors in the event that a user suffers loss as a result of reliance upon the information.