Abnormal Menstrual Cycle & Uterine Bleeding
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Abnormal Menstrual Cycle & Uterine Bleeding

Obstetrics and GynaecologyReproductive Medicine

Menstrual cycle and abnormal bleeding refer to variations in the length, flow, or duration of the menstrual cycle outside the normal range. Irregular menstrual cycles may include intervals between periods that are too long or too short, excessively heavy or light periods, and intermittent bleeding between periods. Abnormal uterine bleeding may involve bleeding outside of the menstrual period. Various factors, including hormonal imbalances, reproductive system disorders, stress, weight changes, or other health issues can cause these conditions.

Normal Menstrual Cycle

The average menstrual cycle for women ranges from 21 to 35 days, averaging 28 days. The typical blood loss is between 30 and 80 ml, and menstruation lasts about 2 to 7 days. Each woman's menstrual cycle and blood volume may vary slightly but is considered normal within these ranges.

Abnormal Uterine Bleeding (AUB)

Abnormal Uterine Bleeding (AUB) refers to uterine bleeding that falls outside the normal ranges for menstrual flow, frequency, cycle, or duration. AUB can arise from various causes, including pregnancy, endocrine issues, hormonal imbalances, clotting disorders, endometriosis, fibroids, or polyps. Treatment depends on the cause and may involve medication, hormone therapy, or surgery.

Dysfunctional Uterine Bleeding (DUB)

Dysfunctional Uterine Bleeding (DUB) refers to abnormal uterine bleeding caused by hormonal imbalance and not due to structural abnormalities within the uterus (already ruled out through diagnostic exclusion). This condition is common in women approaching menopause and young women who have just started menstruating. Treatment options may include hormonal therapy, such as birth control pills, to regulate the menstrual cycle or surgical intervention in more severe cases.

Ovulatory DUB

Ovulatory DUB refers to abnormal uterine bleeding related to the ovulation process. This condition can occur when a woman's ovulation cycle is disrupted, leading to hormonal imbalances. It may result from the body's failure to ovulate normally during the menstrual cycle, affecting hormone levels related to menstruation and causing abnormal bleeding. Treatment typically involves restoring hormonal balance, possibly including hormone therapy or other methods to regulate the menstrual cycle.

Anovulatory DUB

Anovulatory DUB refers to abnormal uterine bleeding caused by the absence of ovulation. This condition is often associated with hormonal imbalances because a regular menstrual cycle requires ovulation to trigger related hormonal changes. When ovulation does not occur, it can lead to irregular or abnormal bleeding. Treatment methods may include hormone replacement therapy or other interventions to restore a regular menstrual cycle and reduce abnormal bleeding.

Diagnosis

In medicine, the diagnosis of menstrual irregularities and abnormal uterine bleeding involves the following steps:

1. Understanding the pattern and nature of the bleeding through a detailed medical history.
  
2. Conducting a physical examination, especially a pelvic exam. Laboratory tests that may be required include hormone level measurements. Imaging studies such as ultrasound or MRI may be performed to detect possible structural abnormalities.
Common diagnostic tests include:

  • Blood tests: Haemoglobin
  • Pregnancy test
  • Cervical smear test
  • Endometrial biopsy
  • Ultrasound
  • Hysteroscopy ± Endometrial biopsy

3. For the diagnosis of dysfunctional uterine bleeding, ovulatory or anovulatory dysfunctional uterine bleeding, the appropriate diagnostic and treatment methods are chosen based on the patient's specific circumstances.

Related Services

Adenomyosis

Obstetrics and GynaecologyReproductive Medicine
Adenomyosis is a condition that affects the uterus in women. It occurs when the tissue from the inner lining of the uterus (endometrium) breaks through the uterine wall and develops into new endometrial tissue within the uterine muscle layer. This growth can cause the uterine tissue to enlarge and thicken, leading to various symptoms.

Breast Disorders

Obstetrics and Gynaecology
Breast Disorders refer to a series of conditions that may affect breast health. When women notice unusual conditions in their breasts, they often assume they have breast cancer. In reality, most breast diseases are benign, and it is best to seek medical follow-up to determine whether the condition is benign or malignant.

Cervical Cancer

Clinical OncologyObstetrics and Gynaecology
Cervical cancer, also known as cancer that occurs in the cervix, is statistically caused by HPV (Human Papillomavirus) infection in over 90% of cases, leading to abnormal cell growth and eventual development of cancer. Cervical cancer is one of the common cancers among women, and women of all age groups are at risk of developing cervical cancer. In Hong Kong, cervical cancer ranks the 7th most common cancer among women and the 9th leading cause of fatal cancer among women. In 2020, there were a total of 556 new cases recorded, with 159 fatalities.

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