A Red Flag from Your Body: Abnormal Uterine Bleeding

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The menstrual cycle is a vital indicator of a woman’s health. However, there are times when bleeding occurs outside of the regular period. This is known as ‘abnormal uterine bleeding’ (breakthrough bleeding). While it can be caused by temporary hormonal changes, it may also be a warning sign from the uterus that requires attention.

Today, Hanaro Medical Foundation will explore the topic of ‘abnormal uterine bleeding’ in women.

The Difference Between Menstruation and Abnormal Bleeding

Normal menstruation maintains a regular cycle and duration, with a consistent pattern of blood flow. In contrast, abnormal bleeding is irregular in timing and appearance. It can occur immediately after a period ends, during ovulation, after sexual intercourse, or even after menopause.

Normal Menstruation	Category	Abnormal Bleeding
Regular cycle	Timing	Irregular occurrence regardless of cycle
Heavy at first, then gradually decreasing	Amount	Sudden heavy or persistent light bleeding
Usually within 3–7 days	Duration	Lasts 1–2 days or more than 7 days

Main Causes of Abnormal Bleeding

The causes of abnormal bleeding can be broadly divided into two categories. Functional causes are primarily due to hormonal imbalances caused by ovulation issues, stress, and other factors. On the other hand, organic causes refer to bleeding resulting from lesions in the uterus or cervix, making it crucial to identify the exact cause.

Functional Causes

– Hormonal imbalance due to ovulation issues, stress, rapid weight changes, or use of contraceptives

– Bleeding that occurs without structural abnormalities in the uterus or cervix

Organic Causes

– Bleeding caused by actual lesions such as cervical cancer, cervical polyps, endometrial polyps, or uterine fibroids

Major Conditions That Cause Abnormal Bleeding

Organic causes involve bleeding due to lesions in the uterus or cervix, and the pattern of bleeding and accompanying symptoms may vary depending on the location of the lesion. Therefore, if symptoms persist or worsen, an accurate diagnosis is necessary.

Cervical Diseases	• Cervicitis, cervical polyps, cervical cancer, etc. • Mainly appears as bleeding after intercourse or repeated painless bleeding
Endometrial Diseases	• Submucosal fibroids (near the endometrium), endometrial polyps, endometrial hyperplasia, endometrial cancer, etc. • Can appear as bleeding unrelated to the menstrual cycle or excessive menstrual flow
Uterine Wall Diseases	• Uterine fibroids, adenomyosis, etc. • Symptoms mainly include heavy periods, menstrual pain, blood clots, abnormal bleeding, and anemia

Necessary Tests for Abnormal Bleeding

When abnormal bleeding occurs, it is evaluated step-by-step, considering the timing and pattern of the bleeding, age, and menopausal status. First, the type of bleeding is identified through a medical interview and physical examination. Then, ultrasound and Pap smears are used to check for abnormalities in the uterus and cervix. If necessary, additional tests such as hormone tests or biopsies may be performed.

Key Points to Remember About Abnormal Bleeding

If non-menstrual bleeding repeats or if bleeding after intercourse persists, it should not be taken lightly. The same applies if your menstrual pattern suddenly changes or if bleeding occurs after menopause. Recognizing the significance of these changes and seeking appropriate medical care is essential for protecting women’s health.

This content is excerpted from the column by Dr. Lee Byeong-seok, Executive Director of Hanaro Medical Foundation, in the February issue of ‘Healthy Life,’ a monthly magazine by the Korea Public Health Association. For more details, please refer to the column below. 👇👇👇

Hanaro Medical Foundation Jongno Center 5th Floor, Gran Seoul Tower 1, 33 Jong-ro, Jongno-gu, Seoul Hanaro Clinic, Hanaro Medical Foundation 5th Floor, Gran Seoul Tower 1, 33 Jong-ro, Jongno-gu, Seoul Check-in for this blog

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