Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is one of the most common reasons women seek gynecologic care. It refers to bleeding that is heavier, lighter, longer, more frequent, or less predictable than a normal menstrual cycle.

While hormonal fluctuations are a common cause, abnormal bleeding can also result from fibroids, polyps, thyroid disorders, medications, pregnancy-related conditions, or abnormalities of the uterine lining.

At The Medical Group of New Jersey, our gynecology specialists provide a comprehensive evaluation to identify the cause of abnormal bleeding and develop a personalized treatment plan that improves symptoms while protecting long-term reproductive and overall health.

Symptom Onset & Initial Evaluation

Abnormal uterine bleeding can feel confusing, frustrating, or even alarming, especially when your cycle suddenly changes or bleeding becomes difficult to predict. It can happen at many stages of life, including the teen years, reproductive years, perimenopause, or after menopause.

Some patients notice that their periods gradually become heavier or more irregular. Others experience a sudden change, such as bleeding between periods or bleeding after periods had already stopped.

Common symptoms include:

• Heavy menstrual bleeding
• Bleeding between periods
• Periods that last longer than usual
• Frequent, irregular, or unpredictable cycles
• Bleeding after menopause
• Passing large blood clots
• Fatigue, weakness, or lightheadedness related to blood loss or anemia

During your visit, your gynecologist will take time to understand your bleeding pattern, how long symptoms have been happening, and how they are affecting your daily life. They will also review your medications, medical history, reproductive history, and overall health. A pelvic examination may be recommended to look for possible structural causes of bleeding and determine whether additional testing is needed.

Diagnosis

Finding the cause of abnormal bleeding is important because treatment depends on what is driving the symptoms. In some cases, bleeding is related to hormonal changes. In others, it may be caused by fibroids, polyps, thyroid conditions, pregnancy-related concerns, medications, or changes in the uterine lining.

Diagnostic evaluation may include:

• Pelvic examination
• Pregnancy testing when appropriate
• Blood tests to check for anemia, hormone changes, or thyroid problems
• Pelvic ultrasound to evaluate the uterus and ovaries
• Endometrial biopsy to sample the uterine lining when indicated
• Hysteroscopy in selected cases to look directly inside the uterine cavity

These tests help your gynecologist identify the most likely cause of bleeding and recommend the safest, most effective treatment plan.

Treatment & Ongoing Management

Treatment is personalized based on your age, symptoms, test results, reproductive goals, and preferences. The goal is not only to reduce bleeding, but also to improve comfort, prevent anemia, and address any underlying condition.

Management options may include:

• Observation and monitoring for mild symptoms
• Hormonal medications, including birth control pills or progesterone therapy
• Hormonal IUDs to reduce heavy bleeding
• Treatment of thyroid or other endocrine conditions
• Minimally invasive procedures for fibroids or polyps
• Endometrial ablation in selected patients who do not desire future pregnancy
• Hysterectomy when other treatments are ineffective or not appropriate

Your gynecologist will review the benefits, risks, and expected results of each option. Together, you can choose an approach that fits your health needs, lifestyle, and future pregnancy plans.

Follow-Up Care

Follow-up care helps make sure treatment is working and that bleeding remains well controlled over time. It also gives your gynecologist a chance to adjust your plan if symptoms change.

Follow-up may include:

• Tracking menstrual patterns
• Repeat blood testing for anemia when needed
• Follow-up imaging or biopsy in selected cases
• Medication adjustments if symptoms persist
• Ongoing evaluation during perimenopause or menopause

With the right diagnosis and treatment plan, most patients experience significant improvement in bleeding, energy level, comfort, and overall quality of life.