Although most women have come to know menstruation as a once-a-month cycle, other women experience it more than once a month or bleeding for a long period of time. Several factors play a part in causing abnormal menstrual bleeding, however, abnormal menstrual bleeding as a one off can be perfectly normal.
Normal Menstrual Bleeding
Each month a woman has a 25- to 36-day menstrual cycle, which includes three to seven days of bleeding called a period, according to Merck.com. Period bleeding can be light, medium or heavy in flow and may contain some small blood clots. The menstrual cycle is brought on when the pituitary gland releases the luteinizing and follicle-stimulating hormones. These hormones signal to the ovaries to produce estrogen and progesterone for egg production and fertilization. At the same time, the uterine lining thickens in anticipation of the incoming egg for fertilization. If the egg is not fertilized, the uterine lining sheds and bleeds; this begins day one of the menstrual cycle. During this time, a woman may experience mild cramping, breast tenderness or headache.
Identification
Irregular menstrual bleeding takes several forms. It can be longer than normal menstrual bleeding, extremely heavy flow, scanty periods, missed cycles, heavy bleeding with large blood clots, in-between bleeding, spotting or cycles that are too close together. Irregular menstrual bleeding is experienced by most women at some point, which is perfectly normal. However, experiencing any of these forms of irregular bleeding for more than one cycle is not normal and should be followed up with a physician.
Symptoms
Normal bouts of irregular bleeding may cause no additional symptoms. However, if there is a condition causing the abnormal bleeding, you may have one or more of the following symptoms: facial hair, infertility, male-pattern hair growth, abdominal pain, abundant or foul smelling discharge, heavy blood clotting, brown or bright red staining in underwear between periods, pain with intercourse and bloating.
Causes
Causes of irregular menstrual cycles vary. Irregular menstrual periods are normally caused by fluctuations in the hormones estrogen and progesterone. Sometimes, these hormones can be thrown off course by genetic conditions such as polycystic ovary syndrome and Von Willebrand's disease or by medications that are used to control the menstrual cycle such as birth control, intrauterine devices or the use of fertility medications. Other causes of irregular menstrual bleeding are uterine growths such as uterine fibroids or uterine polyps.
Treatment
Treatment for irregular bleeding consists of both treatments to stop the cause of the bleeding and stopping the bleeding itself. If the cause of bleeding is hormonal, the doctor will prescribe hormone replacement medication or oral contraceptives to correct the hormonal imbalance. In most cases, this will be enough to subside the bleeding. These medications may also correct ovarian and uterine problems such as ovarian cysts and uterine polyps or uterine fibroids. If a blood-clotting disorder such as Von Willebrand's disease is suspected, the doctor may prescribe the use of blood-thinning medication such as warfarin or heparin. If medications are not a solution, the physician may want to explore surgical options to remove any growths that are causing the bleeding. In some rare but serious cases, the doctor may have to remove the uterus completely.
References
- Merck: The Menstrual Cycle
- MJ Bovo: Abnormal Menstrual Bleeding
- Medicinenet: Vaginal Bleeding
- "Mayo Clinic Family Health Book, Third Edition"; Mayo Clinic; 2003
