Abnormal Bleeding Symptoms, Causes, Treatments

abnormal bleeding

What Is Abnormal Bleeding?

Abnormal uterine bleeding (AUB) is a broad term that describes irregularities in the menstrual cycle involving frequency, regularity, duration, and volume of blood flow. It occurs between a woman’s monthly periods or when she bleeds too long or her blood flow is extreme. In contrast, a normal menstrual flow typically lasts approximately five days and occurs every 21 to 35 days.

According to the American College of Obstetricians and Gynecologists (ACOG), bleeding in any of the following situations is considered abnormal bleeding:

  • Bleeding or spotting between periods
  • Bleeding or spotting after sex
  • Heavy bleeding during your period
  • Menstrual cycles that are longer than 38 days or shorter than 24 days
  • “Irregular” periods in which cycle length varies by more than 7–9 days
  • Bleeding after menopause

How Common Is Abnormal Bleeding?

The actual number of women who experience abnormal uterine bleeding is not clearly known because women often don’t report experiencing symptoms. According to the National Library of Medicine, it is estimated that “up to one-third of women will experience abnormal uterine bleeding in their life, with irregularities most commonly occurring at menarche and perimenopause.”

What Are the Symptoms of Abnormal Bleeding?

In addition to the bleeding symptoms as identified above by ACOG, secondary symptoms may be present and worth bringing to the attention of your doctor. These include:

  1. Bloating
  2. Tender breasts
  3. Pain or pressure in the pelvic region
  4. Dizziness or fainting
  5. Weakness
  6. Low blood pressure
  7. Elevated heart rate
  8. Pain
  9. Pale skin
  10. The passage of large blood clots
  11. Bleeding heavily enough to soak a pad every one to two hours

If you are experiencing these symptoms, reach out to us at North Texas Ob-Gyn Associates to schedule an appointment with one of our skilled ob-gyn providers. Treatment might be as simple as hormone replacement therapies to balance your hormones. It’s best to make an appointment as soon as you discover these symptoms to allow our team of doctors to determine the cause early and prescribe the appropriate treatment.

What Are the Causes of Abnormal Bleeding?

1. Hormonal imbalance

Estrogen and progesterone are the two hormones that regulate your cycle. If these hormones become imbalanced, you may begin to spot. 

One thing to be aware of, beginning many hormonal contraceptives will often trigger abnormal bleeding during the first three months. These hormonal contraceptives include birth control pills, intrauterine devices, contraceptive patches, or contraceptive implants or injections. If you are unsure of the hormonal contraceptive you have begun, our doctors can diagnose your symptoms and work with you to bring your body into hormonal balance.

2. Pregnancy complications

Complications during pregnancy can cause spotting. Both a miscarriage and an ectopic pregnancy can cause bleeding. An ectopic pregnancy occurs when a fertilized egg implants itself in the fallopian tube instead of the uterus. Spotting during pregnancy may not mean you’re having a miscarriage. However, if you’re pregnant and experience any vaginal bleeding, you should contact your doctor immediately.

3. Uterine fibroids

Abnormalities in the uterus, such as uterine fibroids and polyps can cause abnormal bleeding. Fibroids are noncancerous growths of the uterus that often appear during childbearing years. Polyps are non-cancerous growths on the lining of the uterus and cervix. 

4. Infection

Vaginal bleeding between periods may indicate an infection of your reproductive organs. Infection can cause inflammation and bleeding. Causes include a sexually transmitted infection, vaginal douching, intercourse, or pelvic inflammatory disease, which is marked by inflammation of the reproductive organs that leads to scarring. In “Reproductive Tract Infections,” the CDC offers a thorough explanation of these infections.

5. Cancer

Less common but also a possible cause of abnormal bleeding is cancer of any of these organs: the cervix, vagina, uterus, or ovaries.

6. Rare causes

Other possible causes of vaginal bleeding are rare and include insertion of an object into the vagina, stress, diabetes, thyroid disorders, and significant weight gain or loss. These causes can be easily treated at our office.

When to Seek Medical Help

Schedule a consultation with your doctor any time you have abnormal vaginal bleeding. The cause of the bleeding could be serious and should be determined. Our team of doctors has 30+ years of experience treating women with abnormal bleeding, and a visit with one of them will set you on the path of recovery.

What to Expect at Your Visit


When talking to your doctor about abnormal bleeding, be prepared to answer questions about your symptoms.

We recommend that you record your cycle. Take note of when your periods begin and end, the heaviness and duration of your flow, and when and how much you bleed between periods. Download an app for your phone to make this a simple process. Find some apps here in this blog. To best diagnose your case, your doctor will want to know about any symptoms that you’re experiencing and any medications that you’re taking.


Your doctor will also likely give you a physical exam, including a pelvic exam. Diagnostic tests can help your doctor find the cause of the bleeding. Your doctor may draw blood to check hormone levels. You may need to have cultures taken or tissue removed from your cervix or the lining of your uterus for testing, which is called a biopsy. Your doctor may also want to perform an ultrasound.

Treatment for Abnormal Bleeding 

Fortunately, modern medicine offers several treatment options for abnormal bleeding. Your treatment will depend on the cause of your bleeding, your age, and whether you want to get pregnant in the future. Our ob-gyn providers will advise you on your options and help you decide which treatment is right for you. 

The treatment options may include hormonal replacement therapy and/or minimally invasive procedures and surgery. 

  • Bioidentical Hormone Replacement Therapy

Over the past 30 years, our ob-gyn providers have successfully treated women suffering from abnormal uterine bleeding with BHRT. To learn more about BHRT and how it safely helps women achieve hormonal balance, read this helpful blog from North Texas Vitality, “What are Bioidentical Hormones?”

  • Minimally Invasive Endometrial Ablation

Endometrial ablation is the removal of the lining of the uterus and has become a well-established alternative to treat abnormal uterine bleeding according to the Journal of Obstetrics and Gynecology Canada. It is a safe, outpatient procedure that allows women to resume their life within days. 

  • Minimally Invasive Robotic Surgery

If treatment should require surgery, our ob-gyn providers will most likely perform minimally invasive surgery. This is the latest development in surgery, allowing doctors to use a variety of techniques including robotics to safely operate on patients with less risk to the body than with open surgery. Dr. Fliedner, one of our providers, is known for his expertise in minimally invasive robotic surgery and is often asked to counsel and train other surgeons on the details of this refined skill.

Questions About Abnormal Bleeding

We are here to help you. If you are experiencing abnormal uterine bleeding, contact our office to schedule an appointment by calling (972-436-7557). Contact us if you have any questions. Our ob-gyn providers have over 30+ years of experience treating women with abnormal bleeding. They will diagnose your symptoms and recommend the best treatment plan to relieve your suffering and bring back hormonal balance.