Irregular or abnormal periods (abnormal uterine bleeding)

Overview

A normal cycle is usually 21 to 35 days, with bleeding for up to 7 days. Bleeding outside that pattern is called abnormal uterine bleeding.

Common causes include hormone shifts (in teens, near menopause, with PCOS or thyroid problems), fibroids, polyps, birth control, pregnancy problems, and, less often, cancer.

Symptoms

Common signs:

• Irregular periods
• Bleeding after sex or between periods
• Very heavy or long periods

Less common

• Tiredness from low iron
• Passing large clots

When to get medical care

Causes

Hormone changes, PCOS, thyroid problems, fibroids, polyps, birth control, pregnancy problems, bleeding disorders, and cancer.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Teen years and the years before menopause
• PCOS
• Obesity

Possible complications

• Anemia: From losing blood

Diagnosis

A healthcare professional asks about your cycle and does an exam.

Questions you may be asked

• Dates and flow of recent periods
• Chance of pregnancy
• Birth control and other medicines

The exam

A pelvic exam.

Tests

Tests, if needed:

• Pregnancy test:
• Blood tests: For anemia, thyroid, and hormones.
• Pelvic ultrasound: To look for fibroids or polyps.
• Biopsy: A sample of the uterine lining, often for people over 45.

Treatment

Treatment depends on the cause and whether you want to get pregnant.

Self-care

• Track your periods: an app or calendar helps
• Eat iron-rich foods if bleeding is heavy

Medicines

Medicines that may help:

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Options include hormone treatments, a hormonal IUD, or procedures to remove fibroids or polyps or thin the lining.

Prevention

You can't prevent every cause, but:

• Keep up with checkups
• Track your cycles

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a gynecologist (OB-GYN).

Children, pregnancy, and older adults

• Teens: Irregular periods are common in the first few years.
• Menopause: Any bleeding a year or more after periods stop needs a check.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Most causes can be treated well.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• Period tracking for 2 to 3 months

Questions to ask

• What's causing my bleeding?
• Do I need a biopsy?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Irregular or abnormal periods (abnormal uterine bleeding)