1. Health

Diagnosis and Treatment of Abnormal Uterine Bleeding


Updated June 19, 2014

A pelvic exam is the first step to determine the cause of abnormal uterine bleeding, including a Pap smear and lab tests to check for any underlying causes, as well as a pregnancy test when appropriate. An ultrasound is often performed to check for any abnormalities, such as fibroids. And an endometrial biopsy, D&C, or hysteroscopy may also be performed to further evaluate the condition of your uterus.

Treatment of Abnormal Uterine Bleeding

Relief from abnormal uterine bleeding or menorrhagia is usually found by treating either the medical or physical (as in the case of an IUD) cause. Abnormal bleeding which does not appear to be related to another underlying disease or condition is often successfully treated with progesterone or a combination of progesterone with estrogen, many times given in the form of an oral contraceptive.

Women who experience menorrhagia, or excessive uterine bleeding, on a regular basis should be monitored closely for anemia and treatment with iron supplementation may be necessary. Often, severe bleeding is treated with non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. These drugs sometimes help reduce bleeding, as well as menstrual cramps.

Endometrial ablation, once commonly used to treat excessive bleeding in women past child bearing who wanted to avoid hysterectomy, has now been replaced by a therapy called thermal balloon ablation. In most cases, thermal balloon ablation ends bleeding by destroying the lining of the uterus. Only women who do not want to have children are treated in this manner because this treatment usually results in infertility. However, this procedure does not guarantee that pregnancy won't happen. Women who do not desire children should continue using their preferred birth control method.

Unless you're pregnant when you experience abnormal uterine bleeding, a single episode of heavy menstrual bleeding usually does not require treatment. The exception to this, however, is when excessive uterine bleeding continues for over 24 hours. Women should contact their gynecologists.

Contact your gynecologist whenever you're unsure about any reproductive health symptom you experience.


ACOG Patient Education. Abnormal Uterine Bleeding. http://www.acog.org/publications/patient_education/bp095.cfm. Accessed 07/12/09.

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