Hormonal vaginal bleeding is abnormal bleeding from the vagina that is due to changes in hormone levels.
Every woman's menstrual cycle, or period, is different. On average, a woman's period occurs every 28 days. Most women have cycles between 24 and 34 days apart. It usually lasts 4 - 7 days.
Young girls may get their periods anywhere from 21 to 45 days or more apart. Women in their 40s will often notice their period occurring less often.
About every month, the levels of female hormones in a woman's body rise and fall. Estrogen and progesterone are two very important hormones. These hormones play an important role in ovulation, the time when the ovaries release an egg.
Dysfunctional uterine bleeding (DUB) most commonly occurs when the ovaries do not release an egg. Changes in hormone levels cause your period to be later or earlier and sometimes heavier than normal.
Symptoms of dysfunctional uterine bleeding may include:
Other symptoms caused by changes in hormone levels may include:
A woman may feel tired or have fatigue if she is loses too much blood over time. This is a symptom of anemia.
The health care provider will do a pelvic examination and may perform a Pap smear. Tests that may be done include:
Your health care provider may recommend the following:
Young women within a few years of their first period are often not treated unless symptoms are very severe, such as heavy blood loss causing anemia.
In other women, the goal of treatment is to control the menstrual cycle. Treatment may include:
The health care provider may recommend iron supplements for women with anemia.
If you want to get pregnant, you may be given medication to stimulate ovulation.
Women with severe symptoms that do not get better with other treatments may consider the following procedures if they no longer want to have children:
Hormone therapy usually relieves symptoms. Treatment may not be needed if you do not develop anemia due to blood loss.
Call your health care provider if you have unusual vaginal bleeding.
Abnormal vaginal bleeding; Bleeding - dysfunctional uterine; Anovulatory bleeding; DUB; Abnormal uterine bleeding; Menorrhagia - dysfunctional; Polymenorrhea - dysfunctional; Metrorrhagia - dysfunctional; Dysfunctional uterine bleeding
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Middleton LJ, Champaneria R, Daniels JP, Bhattacharya S, Cooper KG, Hilken NH, et al. Hysterectomy, endometrial destruction, and levonorgestrel releasing intrauterine system (Mirena) for heavy menstrual bleeding: systematic review and meta-analysis of data from individual patients. BMJ. 2010 Aug 16;341:c3929. doi: 10.1136/bmj.c3929.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.
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