Abnormal bleeding in women of reproductive age ========================================== What surgical methods are used in the treatment of abnormal uterine bleeding? Some women may need surgery to remove uterine fibroids or polyps. Polyps and some fibroids may be removed through hysteroscopy. Hysterectomy is recommended when the patient does not respond to other treatment methods. Hysterectomy is considered a major surgery, and after performing it, a person will not have a period and will not be able to get pregnant. ### What factors are taken into consideration in deciding on the type of treatment selected for abnormal bleeding? The type of treatment depends on many factors, including the cause of the bleeding, your age, and your desire to have children. Most women are treated with medication, and a few require surgery. ### What medications are used to help control abnormal uterine bleeding? Hormonal drugs are often used to control abnormal uterine bleeding. The type of hormone medication you receive depends on your age and whether you are trying to get pregnant. Birth control pills regulate your period. Hormonal medications can come in other forms, such as injectables, vaginal ointments, and hormone-releasing IUDs. (IUD is a contraceptive device that is inserted into the uterus) Other drugs that may be effective in the treatment of abnormal uterine bleeding include non-steroidal anti-inflammatory drugs (such as mefenamic acid, ibuprofen, etc.), trans-oxamic acid, and antibiotics. Non-steroidal anti-inflammatory drugs reduce uterine cramps and control bleeding. Transexamic acid is used in the treatment of heavy period bleeding. Infections are also treated with antibiotics. How is abnormal uterine bleeding diagnosed? **gynecologist** will find out your problem by asking questions about your menstrual cycle (it is better to write down the date of the period and its length and intensity in the calendar and discuss it with your doctor) and if necessary, blood test including blood cell count, hormone tests or pregnancy test. What tests may be needed to diagnose abnormal uterine bleeding? Based on your symptoms, other tests may be needed, some of which can be done in the doctor's office and some in the hospital: - Ultrasound - Sonohysterography (liquid is sent into the uterus through a narrow tube and ultrasound is performed) Magnetic resonance imaging (MRI) is used in this method. - hysteroscopy; A narrow device is sent into the uterus through the vagina and the image inside the uterus is seen on the monitor. endometrial biopsy or intrauterine tissue sampling; A sample is taken from the tissue inside the uterus through a narrow tube that is sent into the uterus. ### What are the causes of abnormal uterine bleeding? Abnormal bleeding has many causes, including the following: - Pregnancy - abortion - Ectopic pregnancy - Adenomyosis (it is a condition in which the tissue that covers the inside of the uterine cavity grows in the muscular wall of the uterus) - Using some contraceptive methods such as IUD or contraceptive pills - Infection of the uterus or cervix - Blood coagulation problems - Polyps - Endometrial hyperplasia (it is a condition in which the tissue that covers the inside of the uterus grows more than normal) - Certain types of cancer such as uterine, vaginal and ovarian cancer - Polycystic ovary syndrome or ovarian laziness ### At what age is abnormal uterine bleeding more common? Abnormal uterine bleeding can occur at any age. But at certain ages, irregular periods are more common. Including the first years after the start of the first period in a girl (ages 9 to 16 years), menstrual cycles usually do not happen regularly. Also, in the years close to menopause, the intensity of bleeding usually becomes less or more. And the length of the cycle may change. ### What is abnormal uterine bleeding? #### Bleeding in any of the following situations is considered abnormal: - Bleeding between periods - Bleeding after sex Spotting at any time of the menstrual cycle - Period bleeding that is more or longer than usual Bleeding after menopause Menstrual cycles longer than 35 days or shorter than 21 days are considered abnormal. Absence of period for 3-6 months is also considered abnormal. #### What is a normal menstrual cycle? Menstrual cycle means the time from the start of the period to the start of the next period, which is usually about 28 days. Cycles that are less than or more than 7 days. (cycles of 21 days to 35 days) are considered normal.

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