Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signals get thrown off. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer cycles.
Symptoms:
Irregular bleeding can come at different times from month to month and last for different lengths of time. The amount of blood flow may vary from light to extremely heavy with large clots. In some people, the bleeding may be associated with uterine cramps.
Treatments:
If the cause of dysfunctional uterine bleeding is another medical condition, treating that condition should restore normal cycles. Otherwise, treatment is based on the cause, the amount of bleeding and the woman's reproductive goals (whether she wants to have children or not).
• Birth control pills, which combine the hormones oestrogen and progesterone, can regulate and decrease the amount of bleeding. Your doctor may recommend that you take monthly pills containing progesterone only. Women seeking to become pregnant may be treated with medications to help their ovaries ovulate more regularly. Heavy bleeding can be stopped with higher doses of hormone pills — either oestrogen or progesterone. When bleeding is more severe, hospitalization may be necessary.
• If hormonal therapy does not work, a surgical D and C (dilation and curettage) can stop severe cases of bleeding. During this procedure, the tissue lining of the uterus is removed, allowing a healthier lining to take its place.
• If an endometrial biopsy reveals endometrial hyperplasia, which is a thicker and abnormal looking lining, closer monitoring with treatment may be required, especially in older women and postmenopausal women on hormone replacement therapy. Endometrial hyperplasia increases a woman's risk of developing endometrial cancer.
