ABNORMAL UTERINE BLEEDING

Menstruation is considered normal when uterine bleeding occurs every 21 to 35 days and is not excessive. The normal duration of menstrual bleeding is between two and seven days. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine bleeding differs from that mentioned above or the woman has spotting or bleeding between her menstrual periods. Abnormal uterine bleeding may be caused by a variety of factors. The two most common causes are structural abnormalities of the reproductive system and ovulation disorders.

More common structural causes of abnormal uterine bleeding include;

• Benign (non-cancerous) lesions of the uterus such as polyps, fibroids (myomas), and adenomyosis (uterine thickening caused by endometrial tissue moving into the outer walls of the uterus).

• Lesions of the cervix or vagina (benign and cancerous), chronic infections of the endometrial lining (endometritis), scar tissue (adhesions) in the endometrium, and the use of an intrauterine device (IUD) also may be associated with abnormal uterine bleeding.

• Additional causes of abnormal bleeding include medications that can affect the normal release of estrogen and progesterone;

• chronic medical problems such as diabetes mellitus or disorders of the liver, kidney, thyroid gland, or adrenal glands; or other medical problems that can affect the production and metabolism of estrogen and progesterone.

• Emotional or physical stress as well as significant changes in body weight may disrupt the pituitary’s release of FSH and LH and prevent ovulation.