Abnormal Uterine Bleeding

What is normal?

A normal menstrual cycle includes menstrual bleeding roughly every 28 days for a period of 3-7 days. Most women will experience premenstrual syndrome (PMS) symptoms, such as irritability, mood swings and abdominal cramps, which may be uncomfortable.

What is abnormal?

Abnormal uterine bleeding is categorised as any bleeding that is abnormal after menstrual cycles should have stabilised at the age of 16 years old. Abnormal uterine bleeding and menstrual disorders include the following issues:

  • Menstrual cycles which are shorter than 21 days or longer than 35 days

  • Periods which last longer than 7 days

  • Abnormally heavy bleeding during your period
  • Bleeding after menopause
  • Spotting or bleeding between periods (irregular bleeding)
  • Spotting or bleeding after intercourse

If you experience any of the above issues or have overwhelming premenstrual syndrome (PMS) symptoms during menstruation, you should seek medical advice from Dr Marlize Lerm to find out how best to make your menstrual cycle tolerable.

How is abnormal uterine bleeding diagnosed?

Dr Lerm will need to perform a combination of the following tests to diagnose the cause of your symptoms accurately. She may make use of the following diagnostic procedures:

  • An ultrasound may be used to give her an image of the pelvic organs and view abnormalities and growths.
  • Hysteroscopy, which is a thin scope may be inserted into the vagina to the cervix, may be used by your gynaecologist to view the uterus walls.
  • A sample of the endometrial lining of the uterus may be taken by an endometrial pipelle or other biopsy technique, to test for causes such as cancer or premalignant endometrial hyperplasia.

  • An MRI (Magnetic Resonance Imaging) may be taken to view the internal organs.
  • Or a sonohysterography may be done by placing fluid inside the uterus using a thin tube in order to take internal ultrasound images of the uterus.

Depending on the cause of abnormal uterine bleeding, doctor Lerm may be able to help treat and manage your condition so that your menstrual cycle and periods are less of a burden on your quality of life. She has a special interest in adolescent gynaecology and aiding young women in managing their menstrual cycle, contraception and taking control of their reproductive health.

What treatment is available?

There is no specific treatment for vaginal bleeding between periods. Treatment will vary based on what's causing your abnormal vaginal bleeding but may include birth control methods, antibiotics or hormonal supplements. In severe cases, suitable, surgical procedures such as uterine artery embolisation, endometrial ablation or a hysterectomy may be considered to treat abnormal uterine bleeding.