Abnormal Uterine Bleeding (AUB): A Leading Cause of Anaemia in Menstruating Women. Here’s How to Manage the Condition.
The female reproductive system is intricate, comprising organs like the uterus, ovaries, fallopian tubes, cervix, and vagina. These organs facilitate crucial functions such as menstruation, reproduction, and hormonal balance. However, due to the complexity of this system, women face the risk of various reproductive issues.
One common complication is Abnormal Uterine Bleeding (AUB), prevalent among women of childbearing age. If left untreated, AUB can lead to several health risks, including anaemia—a condition characterized by insufficient healthy red blood cells (RBCs) in the body.
What is abnormal uterine bleeding
In an interview with the OnlyMyHealth team, Dr. Shipra Kunwar, Consultant Obstetrician and Gynaecologist at Manipal Hospital, Kharadi, Pune, describes Abnormal Uterine Bleeding (AUB) as bleeding that occurs at an unusual time or lasts longer than normal. According to her, the condition can manifest as significant bleeding during or after menopause, or bleeding between periods.
Dr. Kunwar highlights several potential causes of AUB, including hormonal abnormalities, uterine fibroids, polyps, endometriosis, pelvic inflammatory disease, blood clotting disorders, and certain medications like hormone therapy or blood thinners.
Research indicates that up to one-third of women may experience AUB at some point in their lives, with irregularities most commonly occurring at menarche (the onset of menstruation) and perimenopause, the transition period leading to menopause when ovaries gradually cease functioning.
Dr. Kunwar further explains that while the typical menstrual cycle occurs every 28 days, various factors can cause deviations, such as cycles lasting every 24 or 34 days. She notes that menstruation usually lasts around 4–7 days, but newly menstruating girls may experience periods spaced anywhere from 21–45 days apart or even further apart. Additionally, as women approach their 40s, they may experience less frequent periods or shorter intervals between them.
The key takeaway emphasized by Dr. Kunwar is the importance of women recognizing variations in their menstrual cycles, particularly when they appear unusual. Misinterpreting AUB as a normal period can elevate the risk of complications, underlining the significance of seeking medical attention for any concerning symptoms.
How To Recognise AUB?
There are many ways in which AUB can occur in the body.
- It can show up as spotting or bleeding between the regular periods.
- It might happen after having sex.
- The bleeding might last for more days than usual.
- AUB can even occur after menopause, although this is not as common.
The Risk Of Anaemia
Dr. Kunwar highlights that anaemia can indeed arise from severe blood loss associated with abnormal uterine bleeding (AUB). Anaemia is a condition characterized by insufficient production of healthy red blood cells (RBCs), which are responsible for transporting oxygen to the body’s tissues.
According to the World Health Organization (WHO), anaemia is prevalent among specific demographic groups, including young children, menstruating adolescent girls and women, and pregnant and postpartum women. Globally, anaemia affects approximately 40% of children aged 6–59 months, 37% of pregnant women, and 30% of women aged 15–49 years.
Some common symptoms of anaemia include:
- Feeling exceptionally weak or exhausted
- Difficulty performing daily activities due to muscle weakness
- Dizziness or lightheadedness
- Shortness of breath
- Pale skin
- Irregular heartbeat
- Headaches
About the treatment of abnormal uterine bleeding and anemia
Dr. Kunwar outlines various treatment options for managing anaemia and abnormal uterine bleeding (AUB), addressing both the bleeding itself and the underlying causes. Here are the treatment options she mentions:
Medical Treatments:
1. Hormonal Medications: Hormonal therapy, including progestin therapy, hormone replacement therapy, or birth control pills, can help regulate menstrual bleeding and address hormonal imbalances contributing to AUB.
2. Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs can help reduce menstrual pain and decrease blood flow during menstruation, thereby alleviating symptoms of AUB.
3. Tranexamic Acid: This medication helps to promote blood clotting and control excessive menstrual bleeding in women with AUB.
4. Gonadotropin-Releasing Hormone (GnRH) Agonists: GnRH agonists can suppress ovarian function, leading to a reduction in menstrual bleeding associated with conditions such as fibroids or endometriosis.
Surgical Interventions:
1. Endometrial Ablation: This procedure involves removing the uterine lining to reduce or eliminate menstrual bleeding, providing relief for women with AUB.
2. Uterine Artery Embolization (UAE) or Myomectomy: These surgical procedures are used to remove uterine fibroids, which can contribute to AUB.
3. Hysterectomy: In severe cases of AUB where other treatments have failed or if there is a significant risk to health, removal of the uterus may be recommended as a last resort.
Iron Supplementation:
Iron supplements are prescribed to address anaemia caused by chronic blood loss associated with AUB. Iron supplementation helps replenish iron stores in the body and improve overall health.
Lifestyle Tips:
1. Healthy Diet: Eating a diet rich in iron, vitamins, and minerals can support the treatment of anaemia and promote overall health.
2. Hydration: Staying well-hydrated is important to maintain blood volume and prevent dehydration, especially during heavy menstrual bleeding.
3. Regular Exercise: Engaging in regular physical activity can enhance general well-being and may help alleviate certain symptoms of AUB.
By utilizing a combination of medical treatments, surgical interventions, iron supplementation, and lifestyle modifications, individuals can effectively manage anaemia and abnormal uterine bleeding, improving their quality of life and overall health. It’s essential to consult with a healthcare provider to determine the most appropriate treatment plan based on individual needs and medical history.
A Final Word
Dr. Kunwar emphasizes the importance of consulting with a healthcare provider to identify the most effective management strategy for abnormal uterine bleeding (AUB) and anaemia. Regular monitoring by doctors and blood tests to check iron levels are crucial aspects of managing these conditions effectively. By working closely with a healthcare provider, individuals can receive personalized treatment recommendations tailored to their specific needs and medical history. This comprehensive approach ensures that patients receive the appropriate interventions to address both the underlying causes of AUB and anaemia, as well as any associated symptoms or complications. Regular follow-up appointments and ongoing communication with healthcare providers are essential for optimizing treatment outcomes and maintaining overall health and well-being.