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 during your period, cycles that occur too frequently or too far apart, spotting between periods, or any vaginal bleeding that occurs after menopause. Because regular menstruation relies on a delicate balance of hormones and structural health, abnormal bleeding is a very common signal that an underlying issue requires clinical attention.
At Miami Women’s Center, we recognize that irregular or heavy bleeding can disrupt your daily routine, impact your energy levels, and cause significant 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 AppointmentFrequently Asked Questions About Abnormal Bleeding
What qualifies as “abnormally heavy” menstrual bleeding?
Menstrual bleeding is clinically considered abnormally heavy (menorrhagia) if it disrupts your quality of life or meets any of the following parameters:
- Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
- Needing to use double sanitary protection (such as a tampon and a pad simultaneously) to control your flow
- Waking up during the night to change your sanitary protection
- Passing blood clots that are the size of a quarter or larger
- Experiencing a menstrual flow that lasts longer than 7 consecutive days
- Feeling constantly fatigued, weak, or short of breath during your period (common symptoms of iron-deficiency anemia)
What are the most common causes of abnormal bleeding?
To systematically categorize and identify the causes of abnormal bleeding, gynecologists utilize a medical acronym known as PALM-COEIN:
- Structural Causes (PALM): Polyps (benign growths in the uterine lining), Adenomyosis (endometrial tissue growing into the uterine muscle wall), Leiomyomas (uterine fibroids), and Malignancy or hyperplasia (abnormal cell overgrowth).
- Non-Structural Causes (COEIN): Coagulopathy (bleeding disorders), Ovulatory dysfunction (irregular ovulation due to conditions like PCOS or thyroid issues), Endometrial primary disorders, Iatrogenic causes (side effects from medications or IUDs), and Not yet classified factors.
Is spotting between periods normal?
Occasional, very light spotting can occur around the time of ovulation and is generally harmless. However, persistent or unpredictable bleeding between periods is not considered normal and should be evaluated. Intermenstrual bleeding can stem from hormonal imbalances, cervical or uterine polyps, vaginal or cervical infections, a displaced intrauterine device (IUD), or early changes in cervical or uterine cells.
When is vaginal bleeding considered a medical emergency?
You should seek immediate emergency medical care or contact Miami Women’s Center right away if your vaginal bleeding is accompanied by:
- Bleeding so rapid that it thoroughly soaks through two or more maximum-absorbency pads per hour for more than two hours in a row
- Severe, debilitating pelvic or abdominal pain
- Unexplained dizziness, lightheadedness, fainting, or pale skin
- A positive pregnancy test accompanied by sudden bleeding and pelvic pain (signs of a potential ectopic pregnancy)
Our Diagnostic & Treatment Approach
When you visit Miami Women’s Center to address abnormal bleeding, we tailor your evaluation and management plan to your age, lifestyle, and reproductive goals:
- Comprehensive Diagnostics: We utilize high-resolution pelvic ultrasounds (both transabdominal and transvaginal) to visually check for structural issues like fibroids or polyps. We also order targeted blood panels to check your hormone levels, evaluate your thyroid function, and screen for iron-deficiency anemia.
- Hormonal Therapies: For non-structural or ovulatory bleeding issues, we frequently prescribe targeted hormonal birth control options (pills, patches, or vaginal rings) or place a progestin-releasing IUD (such as Mirena®) to significantly thin the uterine lining, lighten your monthly flow, and regulate your cycles.
- Minimally Invasive Procedures: If structural abnormalities are found or if medical management does not provide relief, our providers perform advanced, minimally invasive treatments. These include hysteroscopic removal of polyps or fibroids, or specialized in-office procedures like an endometrial ablation (such as NovaSure®) to permanently reduce or stop heavy bleeding for women who have completed childbearing.