A normal menstrual cycle usually lasts for 2 – 7 days, has a frequency of 24 – 38 days, and has a blood loss of 5 – 80 milliliters. Abnormal uterine bleeding (AUB) is a broad term that describes irregularities in the menstrual cycle which has frequency, regularity, duration, and volume of flow outside of pregnancy.1  

AUB affects the physical and mental health of the affected woman. It involves heavy menstrual bleeding, flooding accidents, which can lead to discomfort, tiredness, and depression.2 Blood loss can also cause iron-deficiency anemia. The mental and physical symptoms lead to social isolation, have negative effects on work and may also lead to financial implications, due to missed work. There are also incidences such as clothes or bedding getting damaged by flooding of the menstrual products.2   The structural causes of AUB such as uterine fibroids also has a negative impact on the reproductive outcome. It reduces the chances of natural conception and leads to less successful assisted reproductive techniques. It may also have an effect that results in complications during pregnancy.2 

The treatment of AUB is influenced by many factors such as the reason behind AUB, the fertility desire, the clinical assessment of the patients, the presence of other co-morbidities etc. 1 These co-morbidities can be hypertension, diabetes, thyroid disease.3

 Hormonal methods are usually considered to be the first line of treatment. They involve intravenous (IV) estrogen, combined oral contraceptive pills, and oral progestins. A medicine called tranexamic acid is also given which prevents the breakdown of fibrin (the material that clots are made up of) and this further prevents bleeding. Replacing the blood loss with intravenous fluids and blood products is also important while stopping AUB. Polyps (tissue growth) are removed through surgery.1

To reduce the heavy flow and related complications, one should stay hydrated, and consume more vitamin C-rich foods. A lot of iron gets lost to overcome it including iron-rich food in the diet will help, also one can use iron utensils for cooking.3

In India, the prevalence of AUB is approximately 18% and it is most common among the age group ranging from 40 – 49 years. A detailed history along with a focus on age, and type of bleeding pattern supported by gynecological examination is essential to arrive at a proper diagnosis.4 While the prognosis for AUB is favorable, it also depends on the etiology. It is important to have an open discussion regarding menstrual with your healthcare provider so that AUB can be identified at an initial level and the appropriate steps can be taken for its treatment.1

References:

1. Davis E, Sparzak PB. Abnormal uterine bleeding. [updated 2022 Sep 9]. In: statpearls [Internet]. Treasure Island (FL): statpearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532913/
2. Jain V, Chodankar RR, Maybin JA, et al. Uterine bleeding: how understanding endometrial physiology underpins menstrual health. Nat Rev Endocrinol. 2022;18(5):290-308.
3. Healthline. How to stop heavy periods 22 options for treatment. [Internet] updated 2023 Mar 8 [cited 2023 Jun 30]. Available from: https://www.healthline.com/health/how-to-stop-heavy-periods.
4. Vaidya R, Vinayachandran S, Devi S, et al. Prevalence of abnormal uterine bleeding and its associated risk factors in women of Perimenopausal Age Groupa retrospective study. Journal of clinical and diagnostic research. Published online 2022.