Understanding Abnormal Uterine Bleeding
Abnormal uterine bleeding (AUB) is a broad medical term that refers to any vaginal bleeding from the uterus that is irregular in timing, duration, or volume compared to a typical menstrual cycle. This includes bleeding that is unusually heavy, cycles that occur too frequently or too far apart, spotting between periods, or any vaginal bleeding after menopause.
At Miami Women’s Center, we recognize that irregular or heavy bleeding can disrupt your daily routine and cause worry. Our medical team provides comprehensive diagnostic workups to identify the precise physical or hormonal causes of your bleeding, offering advanced medical therapies and minimally invasive procedures to restore a healthy, predictable cycle.
Request an AppointmentOur Diagnostic & Treatment Approach
When you visit us to address abnormal bleeding, we tailor your evaluation and management plan to your age, lifestyle, and reproductive goals:
- Comprehensive diagnostics: High-resolution pelvic ultrasounds to check for structural issues like fibroids or polyps, plus targeted blood panels for hormone levels, thyroid function, and iron-deficiency anemia.
- Hormonal therapies: For non-structural or ovulatory bleeding issues, we frequently prescribe hormonal birth control or place a progestin-releasing IUD to thin the uterine lining, lighten flow, and regulate cycles.
- Minimally invasive procedures: If structural abnormalities are found or medical management doesn’t provide relief, our providers perform hysteroscopic removal of polyps or fibroids, or an endometrial ablation to permanently reduce or stop heavy bleeding for those who’ve completed childbearing.
Frequently Asked Questions About Abnormal Bleeding
Abnormal Bleeding Care at Miami Women’s Center
What qualifies as “abnormally heavy” menstrual bleeding?
Bleeding is considered abnormally heavy if it involves soaking through a pad or tampon every hour for several hours, needing double protection, waking at night to change protection, passing clots the size of a quarter or larger, a flow lasting longer than 7 days, or fatigue and shortness of breath consistent with anemia.
What are the most common causes of abnormal bleeding?
Gynecologists use the acronym PALM-COEIN: structural causes (Polyps, Adenomyosis, Leiomyomas/fibroids, Malignancy or hyperplasia) and non-structural causes (Coagulopathy, Ovulatory dysfunction, Endometrial disorders, Iatrogenic causes like medication or IUD side effects, and Not-yet-classified factors).
Is spotting between periods normal?
Occasional very light spotting around ovulation is generally harmless, but persistent or unpredictable bleeding between periods should be evaluated, as it can stem from hormonal imbalances, polyps, infections, a displaced IUD, or early cervical or uterine cell changes.
When is vaginal bleeding considered a medical emergency?
Seek immediate care for bleeding that soaks two or more maximum-absorbency pads per hour for over two hours, severe pelvic or abdominal pain, dizziness or fainting, or a positive pregnancy test with sudden bleeding and pain (signs of possible ectopic pregnancy).
Can abnormal bleeding be related to PCOS or thyroid issues?
Yes, ovulatory dysfunction from PCOS or thyroid imbalances is a common non-structural cause of abnormal bleeding, which is why hormone testing is often part of the evaluation.
Will I need an ultrasound to diagnose my bleeding issue?
In most cases, yes. A pelvic ultrasound helps rule out structural causes like fibroids or polyps and is a standard part of the diagnostic workup for abnormal bleeding.
Can abnormal bleeding be treated without surgery?
Often, yes. Many patients respond well to hormonal therapy alone. Surgical or procedural options are considered when structural causes are found or medical management isn’t sufficient.