Abnormal uterine bleeding encompasses a variety of different menstrual bleeding patterns. This broad category can be divided into different bleeding patterns including, but not limited to:
Anovulatory/ Noncyclic Bleeding: Menstrual cycle length is calculated by counting the days from the first day of a menstrual bleed to the first day of the following menstrual bleed. A typical menstrual cycle is predictable, cyclic in nature, and consistently 24 – 38 days in cycle length. With careful menstrual cycle tracking, a pattern should be identified based on a patient’s previous menstrual cycles. Any cycle that is shorter than 24 days in duration or longer than 40 days requires further evaluation for possible anovulatory dysfunction. Non-pregnant women who do not have periods at all and have had a period in the past also require further evaluation.
Heavy Menstrual Bleeding: Heavy bleeding during a menstrual cycle is often based off subjective interpretation of their menstrual flow. Many patients with heavy menstrual bleeding also report presence of blood clots, intense menstrual cramping, and excessive blood loss that may leave them feeling fatigued or lightheaded. For clinical purposes, heavy menstrual bleeding is defined as any amount of menstrual bleeding that is excessive to the point of altering a patient’s quality of life and daily activities. Depending on age and different risk factors this concern is evaluated in a variety of ways in order to rule out structural, hormonal, and malignant causes for the bleeding pattern.
Intermenstrual Bleeding: Inter-menstrual bleeding is any type of unscheduled bleeding not occurring during the predicted menstrual time. This can include spotting mid-cycle, bleeding after intercourse, bleeding after exercise, or any other form of unpredictable bleeding. Any patient with concerns for an irregular bleeding pattern should contact their provider for an evaluation.
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