Patient Information: Abnormal Uterine Bleeding (Heavy, Irregular, and/or long Periods) in the Emergency Room
What is Abnormal Uterine Bleeding (AUB)? AUB is menstrual bleeding that is heavier and/or longer than expected. This includes:
A period that lasts longer than 7-8 days in a row. Bleeding that comes more often than every 3 weeks. Heavy menstrual bleeding that causes tiredness, dizziness or other signs of anemia.
What causes AUB? In girls and young women, AUB is usually caused by hormones. Estrogen is the hormone that is made at the beginning of puberty and causes the lining of the uterus to get thicker. Progesterone is the hormone made by the body after ovulation, and it causes the lining of the uterus to mature and then get thin over time. For many girls and young women, ovulation doesn’t happen regularly for the first years after getting their first period. The lining of the uterus gets thicker because of the estrogen present. When you don’t ovulate every month (and get enough progesterone), periods can be irregular, frequent, heavy and very long.
Another less common cause of AUB is a bleeding disorder, which means the blood isn’t clotting like it should. Fibroids, polyps, or other growths are almost never the cause of bleeding in girls and young women.
What tests are needed? You will have a complete blood count (CBC) and iron studies done, which test for anemia. Girls and teens who have anemia from their bleeding should also be tested for a bleeding disorder.
In most cases, AUB will be caused by hormones.
How is AUB treated? Treatment is different for everyone, but here are some common options. Several may be used:
If your have anemia or low ironyou’ll be put on aniron supplement. You’ll need to keep taking it until your iron levels are back to normal.
Treatment with hormonal medicine to stabilize the lining of the uterus. Hormonal medicines can include:
o Birth control pills - not forf birth control, but to give you the hormones needed to stabilize the lining of the uterus. o Progesterone pills. o A combination of birth control pills and progesterone. Ibuprofen to help with any cramps and also lessen the amount of bleeding.
If you don’t have anemia you and your family may choose not to start any treatment.
What follow-up is needed? It is very important that you follow-up with your regular doctor and/or with a specialist as recommended. If there is heavy bleeding and anemia, this follow-up needs to be within 7 days of your Emergency Room visit.
What else do I need to know? It is very important to get the medicine that was prescribed today and to start taking it immediately. Once hormonal medication in started, the bleeding should lessen or stop within several days. Contact you doctor or come back to the Emergency Room if the bleeding increases again or if you have any new concerns.
Author: Adolescent Gynecology Clinic | Approved by Patient Education Committee | Valid through 2020 The information presented is intended for educational purposes only. It is not intended to take the place of your personal doctor’s advice and is not intended to diagnose, treat, cure or prevent any disease. The information should not be used in place of a visit, call or consultation or advice of your doctor or other health care provider.
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