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Abnormal uterine bleeding: Reason to worry

Sarah Kelsey is a lifestyle writer, editor and spokesperson based in Toronto. She was the editor of AOL/The Huffington Post Canada’s StyleList, Style and Living sites. Today, she's a freelancer writing for some of North America’s top pub...

AUB: Causes and prevention

Affecting more than 10 million women, abnormal uterine bleeding (AUB) accounts for approximately one-third of all visits to the gynecologist. SheKnows spoke with New York-based gynecologist Dr. Steven Goldstein, author of Could it be… Perimenopause? and The Estrogen Alternative, to learn more about AUB and when to be worried about abnormal uterine bleeding.

5 Questions with an AUB specialist In your own words, what is abnormal uterine bleeding?

Dr. Steven Goldstein: AUB would be defined as any bleeding that occurs between normal periods. This could be the result of some hormonal imbalance or it can be the result of some abnormality in terms of pathology such as polyps and fibroids, precancerous or, even occasionally, cancerous. When should a woman worry about bleeding in between her periods?

Dr. Steven Goldstein: A woman over the age 35 who has AUB must be evaluated according to the guidelines of the American College of Obstetricians and Gynecologists. Common sense would dictate if the bleeding is a one-time occurrence, which does not repeat itself, there is no cause for alarm. If the bleeding continues, a woman should seek evaluation from her physician. Is abnormal bleeding a sign a woman may have a more serious underlying condition?

Dr. Steven Goldstein: Absolutely, although uterine cancer can present without AUB. Other conditions that are not life threatening but can be anatomically abnormal, such as fibroids or polyps, can result in abnormal bleeding. How can a woman go about getting tested for abnormal uterine bleeding?

Dr. Steven Goldstein: A woman with abnormal uterine bleeding should go to her gynecologist. In the past, the first step was often an endometrial biopsy. More current information has shown that blind endometrial biopsy gets a very small portion of the uterine tissue and may be fraught with error. A more modern approach is employing transvaginal ultrasound and a test called saline infusion sonohysterography whereby a small amount of saline can be instilled into the uterus during a simple transvaginal sonogram. Such a test is virtually painless and can be performed by most gynecologists utilizing ultrasound, which is a safe and common technique. What can women do to protect their reproductive health and prevent abnormal bleeding?

Dr. Steven Goldstein: Protecting reproductive health best comes from avoiding sexual transmitted diseases and practicing safe sex. Preventing AUB may be a bit more difficult. In very rare instances it might be related to diet or medication and/or weighing too much or weighing too little. For the overwhelming majority of women, AUB is not necessarily preventable, but it can be diagnosed promptly and treated appropriately.

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