Understanding Abnormal Bleeding
This information is for general education only and is not medical advice. It cannot replace a diagnosis or treatment plan from a qualified healthcare provider who knows your history. Always talk with your own doctor about your symptoms and options.
Abnormal uterine bleeding includes any bleeding that differs from your normal menstrual pattern. This can mean periods that are excessively heavy, last longer than 7 days, occur more frequently than every 21 days, or occur between periods.
The causes can range from hormonal imbalances and fibroids to polyps, adenomyosis, and other structural issues. A specialist can identify the cause and recommend treatment options, many of which are minimally invasive.
Do I have abnormal bleeding?
These conditions are often complex to diagnose and can look different in every patient. If several of these feel familiar, it's worth talking to a specialist.
Heavy periods
Soaking through pads or tampons every 1-2 hours, or needing to double up.
Periods lasting more than 7 days
Prolonged bleeding beyond the typical menstrual cycle duration.
Bleeding between periods
Spotting or bleeding that occurs outside of your regular menstrual cycle.
Passing large blood clots
Clots larger than a quarter during menstruation.
3,400+ AAGL member surgeons list abnormal bleeding as a focus area
These surgeons have identified abnormal bleeding as an area of focus in their own listing. AAGL does not verify this information. Inclusion is not an endorsement.
How is abnormal bleeding treated?
Treatment depends on your symptoms, severity, and goals. Here are the most common approaches, with an emphasis on minimally invasive options.
Hysteroscopy
A minimally invasive procedure to visualize and treat conditions inside the uterus, such as polyps or fibroids.
Endometrial ablation
Destruction of the uterine lining to reduce or stop heavy bleeding. It is intended for people who have completed childbearing, because it is not recommended for anyone who may want to become pregnant in the future. Your surgeon will discuss whether it is right for you.
Hormonal therapy
IUDs, birth control pills, or other hormonal treatments to regulate bleeding.
Myomectomy
Surgical removal of fibroids if they are the cause of abnormal bleeding.
When to seek care urgently
This page is for education, not diagnosis. Some symptoms need prompt medical attention. Seek urgent care or call your local emergency number if you experience:
- Severe or sudden pelvic or abdominal pain
- Heavy vaginal bleeding that soaks through a pad or tampon every hour for two or more hours
- Fever with pelvic pain
- Fainting, dizziness, or a racing heart
- Bleeding during pregnancy, or severe pain during pregnancy
- Bleeding heavy enough to soak a pad or tampon every hour for two or more hours, or bleeding with weakness, dizziness, or a racing heart, needs urgent evaluation.
Frequently asked about abnormal bleeding
When is heavy bleeding considered abnormal?
Bleeding is considered abnormal if you soak through a pad or tampon every 1-2 hours, your periods last more than 7 days, or you pass clots larger than a quarter.
Do I need surgery for abnormal bleeding?
Not always. Many cases can be managed with medication. However, if there is a structural cause like fibroids or polyps, minimally invasive surgery may be recommended.
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Medical Disclaimer
The information on this page is provided by Gynawareness, an educational initiative of the American Association of Gynecologic Laparoscopists (AAGL), for general informational and educational purposes only. It is not intended as, and should not be used as, a substitute for professional medical advice, diagnosis, or treatment.
Every patient is unique. Treatment options, risks, benefits, and outcomes depend on individual medical history, current health status, and clinical findings that can only be evaluated by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or treatment.
Do not delay seeking medical care, disregard professional medical advice, or stop a prescribed treatment because of information you have read on this site. If you believe you have a medical emergency, call your physician or 911 immediately.
Gynawareness and the AAGL do not endorse any specific test, product, procedure, opinion, surgeon, or other information that may be mentioned on this site.