Dysfunctional Uterine Bleeding
Key points
- Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle.
- Irregular bleeding can come at different times from month to month and last for different amounts of time.
- Your doctor will ask about your medical history and about symptoms that might suggest a cause for the irregular bleeding or other hormonal abnormalities.
- Most women have a period that is irregular in timing or amount of bleeding at some point during their menstrual years, most often because of a cycle without a normal ovulation.
What Is It?
Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signaling gets thrown off. It can include alternating heavy and light periods or spotting, or unpredictable shorter and longer cycles.
The regular monthly menstrual cycle flushes out the endometrial lining, the blood-enriched layer of tissue that grows inside the uterus every month in anticipation of a possible pregnancy.
If ovulation does not occur, periods can be delayed, which allows the endometrial lining to grow thicker. For that reason a delayed period is often a heavy one.
Lighter periods or spotting between periods may represent leakage from an endometrial lining that is unstable, either because hormonal levels don't adequately support it or because the lining may be too thick.
Other factors that can change bleeding patterns include:
- Certain hormonal abnormalities (thyroid problems, hyperprolactinemia)
- Medications
- Excessive exercise or weight loss
- Stress or illness
- The start of menstruation in adolescence — Regular ovulatory cycles may not develop for a few months or even years.
- The end of menstruation — Dysfunctional uterine bleeding is also common in the months to years before menopause.
Symptoms
Irregular bleeding can come at different times from month to month and last for different amounts of time. The amount of flow also may vary from light or scant to extremely heavy with large clots.
Diagnosis
Your doctor will ask about your medical history and about symptoms that might suggest a cause for the irregular bleeding or other hormonal abnormalities. The doctor may perform various tests to rule out these causes of the abnormal bleeding patterns:
- Pregnancy — Urine or blood tests
- Thyroid hormone and prolactin hormone abnormalities — Blood tests
- Menopause (especially in a woman in her 40s or 50s) — Blood tests to determine if estrogen levels are falling, which suggests of the beginning stages of menopause
- Abnormalities of the uterus or ovaries — A transvaginal ultrasound, in which a small, rodlike probe is inserted into the vagina to take specific measurements of the endometrial lining
Frequently asked questions
What is dysfunctional uterine bleeding?
Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signaling gets thrown off. It can include alternating heavy and light periods or spotting, or unpredictable shorter and longer cycles. The regular monthly menstrual cycle flushes out the endometrial lining, the blood-enriched layer of tissue that grows inside the uterus every month in anticipation of a possible pregnancy. If ovulation does not occur, periods can be delayed, which allows the endometrial lining to grow thicker.
What are the symptoms of dysfunctional uterine bleeding?
Irregular bleeding can come at different times from month to month and last for different amounts of time. The amount of flow also may vary from light or scant to extremely heavy with large clots.
How is dysfunctional uterine bleeding diagnosed?
Your doctor will ask about your medical history and about symptoms that might suggest a cause for the irregular bleeding or other hormonal abnormalities. The doctor may perform various tests to rule out these causes of the abnormal bleeding patterns:
- Pregnancy — Urine or blood tests
- Thyroid hormone and prolactin hormone abnormalities — Blood tests
- Menopause (especially in a woman in her 40s or 50s) — Blood tests to determine if estrogen levels are falling, which suggests of the beginning stages of menopause
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.