Abnormal genital bleeding (frequency, amount and/or duration) caused by hormonal imbalances. It tends to affect young teenagers (due to an immature hormonal cycle) and premenopausal women over the age of 45.
The primary hormones involved are oestrogen and progesterone, but adrenal or thyroid hormones may also be affected. Contributing factors have been described: emotional stress, sudden weight changes, strenuous exercise and obesity.
As this cycle does not involve ovulation, there is no breast tenderness, mid-cycle pain or vaginal discharge.
It is diagnosed by a clinical history and physical examination. Possible causes should be investigated and a full gynaecological examination should be carried out.
In general, contraceptives correct the hormonal imbalance and abnormal bleeding and are usually used for at least three months.
- Andrew M Kaunitz, MD. Differential diagnosis of genital tract bleeding in women. UpToDate. Oct 13, 2016.
- Andrew M Kaunitz, MD. Approach to abnormal uterine bleeding in nonpregnant reproductive-age women. UpToDate. Oct 13, 2016.
- Committee on Practice Bulletins—Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol 2012; 120:197.
- Committee on Practice Bulletins—Gynecology. Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol 2013; 122:176.
- Dasharathy SS, Mumford SL, Pollack AZ, et al. Menstrual bleeding patterns among regularly menstruating women. Am J Epidemiol 2012; 175:536.
