Abnormal uterine bleeding (AUB) is any bleeding that strays too far from what is considered a healthy monthly period or any bleeding that occurs too far outside of your normal monthly cycle. Sometimes, the cause of abnormal bleeding is minor and easily treated. Other times, abnormal uterine bleeding can be a red flag for an underlying condition that requires medical attention.

So, how do you know what is and isn’t abnormal bleeding? With so many possible causes and overlapping symptoms, it’s not always easy to tell what’s normal and when it’s time to be concerned and ask questions.

If you are a female who is experiencing abnormal bleeding, we understand you might be confused, frustrated, or even a little scared, especially when a quick online search brings up serious possibilities like an STD, uterine or cervical cancer, an embedded or expelled IUD, or even a miscarriage if you’re pregnant.

Take a deep breath—you’re in the right place.

In this guide, you’re not getting unqualified opinions. Our trusted OBGYN Dr. Jefferey Lodge will walk you through what qualifies as abnormal uterine bleeding, what could be causing it, commonly asked questions about abnormal bleeding, and when you should make an appointment with your provider.

What Is Abnormal Uterine Bleeding?

It goes without saying that the most common reason women bleed from their uterus is their monthly period. Having a period is a normal part of a woman’s reproductive cycle. For most women, menstruation typically begins between the ages of 11 and 15 and continues until menopause, which usually occurs in the late 40s to early 50s.

During this time, menstrual cycles vary from woman to woman in both duration and flow. Some women barely bleed at all, while others experience heavier periods that can interfere with daily life. Some cycles arrive like clockwork every 28 days. Others are less consistent and fluctuate in length—or skip months entirely.

For women with unpredictable periods or periods that have always been on the heavy, longer, or painful side–the issue is often so routine that they never stop to think they could be dismissing potential warning signs of something more serious.

It’s easy to assume that hit-or-miss irregular cycles or longer, heavier, or more painful periods are simply part of the natural variation between women. However, certain period patterns can indicate an underlying health issue. Some are harmless, others more concerning.

Additionally, period irregularities are only one way that abnormal uterine bleeding can show up. Abnormal uterine bleeding is not always tied to your period. There are many other reasons for abnormal bleeding that fall outside your cycle.

Abnormal uterine bleeding is considered a medical condition when a woman experiences any bleeding from the uterus that isn’t part of her monthly period, falls outside of what’s considered a healthy menstrual cycle—or simply, what’s normal for you.

Phases of the menstrual cycle

The phases of the menstrual cycle include menstruation, the follicular phase, ovulation, and the luteal phase.

  • Menstruation: The menstrual cycle is the days of the month you are shedding your uterine lining.
  • Follicular: The follicular phase starts on the first day of your period and usually lasts about 14 days. During this time, hormone levels shift, and the uterus lining thickens.
  • Ovulation: Ovulation happens about 2 weeks before your next period, when an egg is released from an ovary.
  • Luteal: This is the last phase. The released egg travels through the fallopian tubes to the uterus. If your body prepares for pregnancy, the uterine lining thickens.

If you are not pregnant, your period will start again. If you are pregnant, you will not have a period.

Signs That Uterine Bleeding Might Be Abnormal

Abnormal bleeding can be scary, especially if it is severe, comes out of nowhere, or is accompanied by other symptoms. But it can also be easy to write off, especially if it is minor, comes and goes, or you’ve had irregular periods most of your life.

Uterine bleeding may be considered abnormal if you experience any of the following:

Your Period Bleeding Lasts Too Long Or Is Unusually Short

A period that lasts less than three days is considered short. In most cases, short periods aren’t a cause for concern.

Some women naturally have lighter, shorter cycles. It’s also common for periods to become shorter while breastfeeding or during perimenopause. Certain types of hormonal birth control can also reduce period length, as can factors like weight loss, weight gain, or high stress levels.

However, consistently short periods may signal an underlying health issue—especially if they’ve changed suddenly or are accompanied by other symptoms, like irregular cycles, missed periods, or difficulty getting pregnant.

Longer periods are typically more concerning. If your period lasts longer than 7 days, it’s considered prolonged.

Periods lasting longer than a week, especially if this is a regular occurrence and is accompanied by heavy bleeding, fatigue, or pelvic pain, may point to a condition that needs evaluation. If your periods are consistently lasting longer than a week, don’t assume this is normal. It’s time to consult your provider.

Period Bleeding That Is Unusually Heavy

Some women naturally have lighter periods, while others consistently have a heavier flow. Bleeding patterns can also fluctuate throughout a woman’s cycle. It’s not uncommon for a period to begin with light spotting, build to a heavier flow for a few days, then taper off again.

So, what is considered heavy period bleeding? Generally, if you’re soaking through one or more pads or tampons every hour for several consecutive hours, that’s classified as heavy menstrual bleeding and could indicate an underlying health issue.

You Have Extremely Painful Periods

While some cramping and moderate discomfort is a normal part of menstruation that many women experience, extremely painful periods are not normal, especially if accompanied by heavier-than-usual bleeding.

Even if irregular, heavy, or painful periods have always been your “norm,” that doesn’t mean they’re healthy or should go unchecked—especially if they’ve become more intense or disruptive over time.

Cycle Irregularities Accompany Period Bleeding

A typical menstrual cycle lasts anywhere from 21 to 35 days, with bleeding that usually lasts around 3 to 7 days. If your cycles are consistently shorter, longer, unpredictable, or if you’re spotting between periods, it could be a sign that something’s off.

You’re Passing Blood Clots

Occasional small clots during your period can be normal, especially on heavier flow days. Normal blood clots are typically no larger than a dime.

However, if you’re frequently passing large clots (larger than a quarter) or if clots are accompanied by heavy bleeding, cramping, or fatigue, this could be a sign of an underlying condition, and your OBGYN should evaluate you.

You’re Experiencing Abdominal Pain or Pressure Outside Of Your Period

Pelvic or abdominal discomfort that happens outside of your period shouldn’t be ignored—especially when paired with unexpected bleeding.

If pain or pressure persists, worsens over time, or interferes with daily activities, it’s essential to seek medical attention.

Bleeding At Unexpected Times

Sometimes, bleeding that occurs outside of your period isn’t actually coming from your uterus. It might be from the cervix, vaginal tissue, or urinary tract.

That said, any bleeding from the uterus that falls outside of your normal cycle, such as spotting between periods, bleeding after sex, or postmenopausal bleeding, is typically considered abnormal and should be evaluated by your OBGYN.

For example, if you’re spotting or bleeding after sex, it might be due to vaginal dryness, friction, or irritation. However, it could also be related to abnormal uterine bleeding caused by cervical inflammation, infection, or something more serious, such as a polyp or precancerous changes.

If the bleeding is accompanied by symptoms such as pelvic pain, pressure, fatigue, dizziness, or signs of infection (such as unusual discharge or odor), it may indicate a more serious problem.

Unless you’re certain the bleeding is minor and linked to something non-uterine, it’s best to be cautious. Bleeding outside of your normal cycle—especially if it’s new or recurring—should be discussed with your doctor.

Bottom Line

What’s not considered normal is bleeding that’s unpredictable, unusually heavy, happens after menopause, or occurs outside of your typical cycle—especially if it follows sex or is accompanied by pain, pelvic pressure, itching, irritation, unusual discharge, or a strong or foul odor. Abnormal bleeding doesn’t always mean something is seriously wrong—but it’s worth paying attention to, particularly if it’s persistent, getting worse, or starting to interfere with your quality of life.

What Causes Abnormal Uterine Bleeding?

Abnormal uterine bleeding isn’t a condition in and of itself—it’s a symptom. And that symptom can stem from a wide range of causes. Some are relatively common and easy to treat, while others may require more thorough evaluation and long-term care.

In some cases, abnormal bleeding is the result of a hormonal imbalance. In others, it may be related to structural changes within the uterus, underlying medical conditions, or even certain medications or devices.

Below are some of the most common and lesser-known causes of abnormal uterine bleeding and how to know when it’s time to talk to your provider.

Common Causes of Abnormal Uterine Bleeding

Hormonal imbalances are the most common cause of abnormal uterine bleeding. Several conditions and life stages can trigger these shifts. While natural changes cause many hormone imbalances—like your monthly cycle, perimenopause, menopause, or even pregnancy—that doesn’t mean they should be ignored.

Here are the most common hormone imbalances or causes of hormone imbalances that can lead to abnormal uterine bleeding:

Fluctuations in Estrogen and Progesterone

When your body’s levels of estrogen and progesterone are off (even slightly), it can disrupt the menstrual cycle, leading to irregular periods, missed periods, or bleeding between cycles.

Estrogen and progesterone work together to regulate the buildup and shedding of the uterine lining. If this balance is disrupted, the lining may build up excessively (causing heavy bleeding) or shed unpredictably (causing spotting or skipped periods).

These fluctuations can stem from stress, extreme weight changes, intense exercise, birth control changes, or chronic conditions like PCOS or thyroid disease.

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that interferes with ovulation. When ovulation doesn’t happen regularly, it can lead to unpredictable bleeding, missed periods, or very heavy periods when the uterine lining eventually sheds.

Anovulation

Anovulation means your body isn’t releasing an egg during the cycle. Without ovulation, progesterone production doesn’t rise to counterbalance estrogen, which often results in a thickened uterine lining and irregular, prolonged, or heavy bleeding.

Perimenopause

As women approach menopause, estrogen and progesterone levels start to shift more erratically. It’s common to experience skipped periods, spotting, or periods that are unusually heavy or longer than usual during this time of transition.

Body Weight and Adipose Tissue

Fat tissue produces and stores estrogen. When body fat levels are too high, excess estrogen can throw off the hormonal balance, especially if it isn’t matched with adequate progesterone. This can contribute to heavier, longer, or more irregular bleeding.

Thyroid Disorders

Your thyroid plays a major role in regulating metabolism, energy, and hormone balance. It works in conjunction with the hypothalamus and pituitary glands, which help control the menstrual cycle.

When thyroid hormone levels are off—whether due to hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)—it can interfere with gonadotropin-releasing hormone (GnRH), a hormone that kicks off the menstrual cycle. As a result, you may experience absent periods, irregular cycles, or unusually heavy bleeding.

Bleeding or spotting during pregnancy is relatively common. About 25% or 1 in 4 women experience bleeding at some point during pregnancy, especially during the first trimester. In fact, light spotting can even be one of the first signs of pregnancy, known as implantation bleeding, which occurs when the fertilized egg attaches to the uterine lining.

In many cases, spotting in early pregnancy isn’t a cause for concern. It may be triggered by hormonal changes, cervical sensitivity (especially after sex), or natural changes in blood flow to the reproductive organs.

That said, not all bleeding during pregnancy is considered normal. Heavier bleeding, persistent spotting, or cramping may indicate something more serious, such as a miscarriage, ectopic pregnancy (when a fertilized egg implants outside the uterus), or a subchorionic hemorrhage.

If you’re pregnant (or think you might be) and notice any bleeding, it’s important to contact your OBGYN. They can help determine the cause, rule out complications, and ensure your pregnancy is progressing safely.

Intrauterine devices (IUDs) are a popular form of long-acting, reversible birth control due to their high effectiveness and low maintenance. These small, T-shaped devices are inserted into the uterus and come in two main types: hormonal and non-hormonal.

If you have an IUD and are bleeding, there are times this is normal and times when it is not.

IUD Bleeding That Is Typically Considered Normal

Not all bleeding with an IUD is a cause for concern. Some types of bleeding are expected and considered completely normal, especially during the adjustment phase or depending on the type of IUD you have.

Bleeding Due to a Normal Period

Some women continue to have a period with an IUD. As long as you aren’t exhibiting any of the abnormal period symptoms mentioned above—such as heavy clotting, bleeding that lasts longer than 7 days, or pain that interferes with daily life—then regular monthly bleeding is normal, particularly if you have a non-hormonal copper IUD.

It is rare that women on hormonal IUDs, such as Mirena, Kyleena, Liletta, and Skyla, experience abnormal uterine bleeding during their period. In fact, most women experience lighter periods, and some may stop having periods altogether. However, abnormal period bleeding is a common side effect with non-hormonal IUDs like Paragard.

That’s because these IUDs use copper to create an environment that’s toxic to sperm, preventing fertilization. Since copper IUDs don’t alter hormone levels, most women continue to have their regular cycle, and many report experiencing heavier or more irregular bleeding—especially in the first 3 to 6 months after insertion.

Bleeding Immediately After IUD Placement

Spotting or light bleeding for several days to a few weeks after IUD placement is common and usually resolves on its own. Your body is adjusting to the device, and the cervix may be slightly irritated from the procedure.

IUD Bleeding That Is Typically Considered Abnormal

If you have an IUD and experience bleeding any time other than your natural cycle, especially if bleeding persists, is heavy, or becomes heavier over time, or if you have large blood clots, severe cramping or pain, unusual discharge, or foul odor, or symptoms of infection– you need to contact your OBGYN as soon as possible.

While some causes of abnormal bleeding related to an IUD are mild and manageable, others are more serious and could require immediate medical attention or, in rare cases, emergency surgery.

Common IUD-related issues that can lead to abnormal bleeding and warrant a visit to your OBGYN include:

Infection or Inflammation

While rare, infections and inflammation can occur after IUD insertion, particularly if there’s an untreated STI or other infection or irritant present at the time of placement. If this were to occur, it most often happens within the first few weeks after insertion.

However, infection or inflammation can also develop later, especially if the IUD shifts, becomes embedded, partially expels, or remains in place beyond its approved lifespan.

Infections like bacterial vaginosis (BV), yeast infections, cervicitis, or endometritis may irritate the uterine or cervical lining and lead to abnormal bleeding, discharge, or discomfort—even if you’ve had the IUD for months or years without issues.

Damage to the Uterine Lining

Though uncommon, IUDs can occasionally irritate or damage the endometrial lining, especially if they are improperly positioned or if there’s an underlying uterine abnormality.

This irritation can trigger ongoing spotting or heavier-than-normal periods. If the bleeding becomes heavier or more prolonged than usual, or if you begin experiencing new pain or abnormal discharge, it’s time to have the IUD evaluated by your provider.

IUD Displacement

This includes when the IUD becomes misaligned, embedded in the uterine wall, or expelled from the uterus altogether. A displaced IUD may not function properly and can cause irregular bleeding, pain, or cramping.

This is not something to ignore. In some cases, especially with embedded IUDs, surgical removal may be necessary.
If you can’t feel your IUD strings or if you experience a sudden change in bleeding patterns, it’s essential to have the IUD checked by your OBGYN. An ultrasound can confirm whether it’s still in the correct position.

Common Questions About IUDs and Abnormal Bleeding

What are signs that your IUD is out of place?

Unusual bleeding, prolonged bleeding, pain during intercourse, pelvic cramping, or an inability to feel the IUD strings may indicate the device has shifted. Contact your healthcare provider. An ultrasound can confirm whether the IUD is still in the correct position.

Why am I suddenly getting my period again with an IUD?

Hormonal IUDs can suppress periods, but it’s also common for cycles to fluctuate or return over time—especially as the device approaches the end of its lifespan or if it wasn’t placed correctly.

When should I be concerned about IUD-related bleeding?

Any bleeding that’s heavy, prolonged, or accompanied by pain, fever, or an unusual odor should be evaluated. Bleeding after the adjustment period (typically 6 months) may suggest a complication.

Which type of IUD is best or least likely to cause abnormal bleeding?

One isn’t necessarily better than the other. The choice between hormonal and copper IUDs depends on your personal preference and health goals.

That said, hormonal IUDs are often preferred for those wanting lighter or no periods or for managing heavy bleeding. While copper IUDs are hormone-free, making them a great option for those who can’t tolerate hormones or prefer a non-hormonal method, they are known to sometimes cause heavier or more painful periods, particularly in the first several months.

If you’re unsure which is best for you, a conversation with your provider can help you weigh the benefits and potential side effects of each.

Birth control pills contain synthetic hormones that prevent ovulation and alter the uterine lining. These hormonal shifts can lead to abnormal uterine bleeding, particularly in the form of breakthrough bleeding or spotting between periods.

This is especially common when:

  • You’re just starting a new pill or brand
  • You’ve recently missed one or more pills
  • You’re taking extended-cycle pills (like Seasonique or Amethyst)
  • You’re on a low-dose or progestin-only pill

Breakthrough bleeding due to birth control pills is usually not dangerous, but it can be frustrating—especially if it continues beyond the first few months of use.

That said, if the bleeding becomes heavier, prolonged, or starts after several months of consistent use, it may be a sign that the dosage isn’t right for you or that another underlying issue needs evaluation.

If you’ve recently started the pill and are experiencing spotting or irregular bleeding, give it a few months to see if your body adjusts. If bleeding persists or worsens, consult your OBGYN about adjusting your dose or switching to an alternative method.

Fibroids are non-cancerous growths that develop in or on the uterus. They’re extremely common (especially during your reproductive years) and can range in size from as small as a pea to as large as a grapefruit.

While not all fibroids cause symptoms, many do. One of the most common is abnormal uterine bleeding. Fibroids can cause periods that are heavier than usual, last longer than a week or involve blood clots. Some women also experience spotting between periods or bleeding after sex.

The size, number, and location of fibroids all influence how disruptive they are. Fibroids that grow inside the uterine lining (submucosal) tend to cause the most significant bleeding, while those on the outer surface (subserosal) may create more of a pressure or fullness sensation in the abdomen. Other symptoms can include pelvic pain or pressure, bloating, back pain, frequent urination, or constipation.

If you’re experiencing prolonged or heavy bleeding and suspect fibroids could be the cause, your OBGYN can confirm with imaging, usually via ultrasound or MRI.

Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus—often on the ovaries, fallopian tubes, or pelvic walls. This tissue still behaves like normal endometrial tissue, thickening and shedding with each menstrual cycle, but because it has no way to exit the body, it becomes trapped and causes inflammation.

This can lead to abnormal uterine bleeding, particularly very heavy or prolonged periods, bleeding between periods, or spotting after intercourse. Endometriosis is also known for causing severe cramping and pelvic pain, especially during menstruation, though pain can occur at other points in the cycle as well. Other symptoms may include bloating, painful bowel movements, pain during sex, fatigue, and sometimes difficulty getting pregnant.

While the exact cause of endometriosis isn’t fully understood, it is a chronic and often progressive condition that affects up to 1 in 10 women of reproductive age. Diagnosis typically requires imaging and, in some cases, laparoscopy. Treatments may include hormonal therapy, pain management, or surgery to remove endometrial lesions.

Pelvic Inflammatory Disease is an infection of the female reproductive organs that is typically caused by bacteria spreading from the vagina to the uterus, fallopian tubes, or ovaries. Most cases of PID develop as a complication of sexually transmitted infections like chlamydia or gonorrhea. However, it can also occur after childbirth, abortion, or IUD insertion if proper screening wasn’t done.

PID can cause abnormal uterine bleeding, including spotting between periods, heavier or longer periods, or bleeding after sex. This happens because the infection can inflame or damage the lining of the uterus and surrounding structures.

Other symptoms often include pelvic or lower abdominal pain, pain during sex, unusual vaginal discharge with an odor, fever, or pain while urinating. In more advanced or untreated cases, PID can lead to scarring of the fallopian tubes and ovaries, increasing the risk of infertility or ectopic pregnancy.

Early diagnosis and treatment with antibiotics are key to preventing long-term complications. If you’re experiencing bleeding alongside pelvic pain or signs of infection, it’s essential to see your provider right away.

Infections of the cervix (the lower part of the uterus that connects to the vagina) can cause abnormal uterine bleeding, especially bleeding after sex or spotting between periods.

Other symptoms may include abnormal vaginal discharge, pelvic discomfort, itching, or pain during sex. If untreated, some cervical infections can spread to the upper reproductive tract and cause complications like pelvic inflammatory disease (PID).

Often, cervical infections are the result of a sexually transmitted infection (STI) such as chlamydia, gonorrhea, trichomoniasis, or herpes simplex virus (HSV). These infections can irritate and inflame the cervix, making it more prone to bleeding, particularly after intercourse or pelvic exams.

However, not all cervical infections are caused by STIs. Cervical inflammation can also result from yeast infections, bacterial vaginosis, allergic reactions, chemical irritations, or pelvic procedures and medical devices that irritate the cervix.

If you’re experiencing spotting or bleeding after sex and believe it may be due to a cervical infection, contact your OBGYN. They will likely perform a pelvic exam, run tests to check for infection, and recommend appropriate treatment—typically antibiotics or antifungal medication, depending on the cause.

Cervicitis refers to inflammation of the cervix and is a very common cause of abnormal uterine bleeding—particularly spotting after sex or bleeding between periods.

In many cases, cervicitis is triggered by a cervical infection or irritation—such as those mentioned in the section above. It may also be caused by trauma or friction, including sexual activity or recent pelvic procedures.

Because inflammation and infection often go hand in hand and symptoms like bleeding, discharge, or pelvic discomfort can overlap—it’s important to get checked. Your OBGYN can determine whether inflammation, infection, or both are present and recommend the appropriate treatment, which may include antibiotics, antifungals, or simply removing the irritant.

Menstrual patterns often run in families. If your mother, sisters, or other close female relatives have consistently experienced heavy, prolonged, or irregular periods, it could point to a shared genetic factor—either hormonal or related to clotting.

That said, just because it runs in your family doesn’t mean it’s normal. While less common, you could have an inherited bleeding disorder that can be a cause of abnormal uterine bleeding. You should talk to your provider about screening for a bleeding disorder. These conditions are often underdiagnosed in women and may not be picked up without specific testing.

Inherited bleeding disorders that may cause abnormal uterine bleeding include the following:

Von Willebrand Disease (VWD)

This is the most common inherited bleeding disorder. It affects the blood’s ability to clot properly and can lead to symptoms such as heavy or prolonged menstrual bleeding, frequent nosebleeds, easy bruising, bleeding after dental work or surgery, and sometimes blood in the stool or urine.

Platelet Function Disorders

These conditions affect how well platelets in your blood stick together to form clots. Even if your platelet count is normal, dysfunctional platelets can lead to prolonged or unexpected bleeding—including unusually heavy menstrual cycles.

Factor XI Deficiency (Hemophilia C)

This clotting disorder is more common in certain populations, such as Ashkenazi Jews. It can cause mild to moderate bleeding symptoms, including heavy periods and prolonged bleeding after minor injuries or procedures.

Hemophilia A or B

Although rare in women, it is possible to be a symptomatic carrier of these more well-known clotting disorders. Women who are carriers may still experience easy bruising, heavy periods, or bleeding complications with surgery or childbirth.

Less Common Causes of Abnormal Uterine Bleeding

While cancer is usually considered a last possibility—after more common causes of abnormal uterine bleeding have been ruled out—it should not be overlooked. In cases where cancer is present, abnormal bleeding is often the first and most noticeable symptom, especially with gynecologic cancers.

Cancers of the uterus, cervix, vagina, or ovaries can cause bleeding that falls outside your regular cycle. This may appear as bleeding after sex, spotting between periods, or postmenopausal bleeding, all of which should be evaluated promptly.

Sometimes, a tumor can block the cervical canal or damage blood vessels, leading to trapped or irregular blood flow. In the case of cervical cancer, the most common cause is long-term infection with high-risk types of human papillomavirus (HPV)—a virus that often goes unnoticed until symptoms like bleeding begin.

Cancers outside the reproductive tract can also play a role. Leukemia, for example, affects blood and bone marrow function and may lead to abnormal uterine bleeding due to impaired clotting.

While most cases of abnormal bleeding are not caused by cancer, it’s important to take symptoms seriously, especially if bleeding is persistent, occurs after menopause, or happens during or after intercourse. Early evaluation allows your provider to rule out more serious conditions and, if necessary, catch cancer in its early stages.

Adenomyosis is a condition in which the same tissue that lines the uterus (endometrium) begins growing into the muscular wall of the uterus. Because this tissue still thickens, breaks down, and bleeds each month like it usually would—but is trapped inside the muscle—it can lead to chronic inflammation and an enlarged, often painful uterus.

One of the most common symptoms of adenomyosis is heavy, prolonged menstrual bleeding, often with severe cramping or the passage of large clots. Some women may also experience spotting between periods. This abnormal bleeding is usually what leads to a diagnosis.

To reduce heavy bleeding from adenomyosis, providers may recommend hormonal therapies like birth control pills, progestin-only treatments, or even a hormonal IUD, which can thin the endometrial lining and ease symptoms. In more severe or treatment-resistant cases, surgery—including endometrial ablation or hysterectomy—may be considered.

Symptoms can be aggravated by anything that increases estrogen levels. That includes obesity, as excess fat tissue produces estrogen, as well as hormonal imbalances or environmental exposures to synthetic estrogens. Managing stress and avoiding hormone-disrupting products may also help reduce flares.

A prolapsed uterus occurs when the uterus descends into—or even outside of—the vaginal canal due to weakened or stretched pelvic floor muscles and ligaments. This is more common in women who have given birth vaginally, are postmenopausal, or have chronic pressure in the abdomen from things like obesity, frequent constipation, or heavy lifting.

While many people associate prolapse with pressure or a feeling of something “falling out,” vaginal bleeding can also be a symptom—especially when the cervix becomes irritated or exposed due to its lowered position. Some women experience spotting after physical activity or intercourse, while others may have persistent light bleeding.

If bleeding occurs with uterine prolapse, treatment options vary depending on the severity and underlying cause. For mild cases, pelvic floor exercises and lifestyle changes may help. A vaginal pessary—a removable device inserted into the vagina—can support the uterus and reduce irritation. In more advanced cases, especially if bleeding continues or the prolapse worsens, surgical intervention may be needed to repair or remove the affected tissue.

You should speak with your OBGYN if you’re experiencing pelvic pressure, bleeding, urinary symptoms, or a visible bulge of tissue from the vagina. These are signs that the prolapse may be progressing or causing complications. Even if you’ve had mild prolapse symptoms for years, new bleeding should never be ignored.

Some liver diseases, such as cirrhosis or chronic hepatitis, can cause abnormal uterine bleeding. This is because the liver plays a crucial role in metabolizing and clearing hormones such as estrogen and progesterone from the body.

When liver function is impaired, these hormones can build up and disrupt the normal menstrual cycle. In addition, liver disease can reduce the production of clotting factors, which may increase the risk of bleeding and cause periods to be heavier or longer than usual.

Like the liver, the kidneys help regulate hormone balance in the body and play a role in overall metabolic function. In chronic kidney disease (CKD), hormone clearance becomes less efficient, which can interfere with the menstrual cycle and contribute to irregular or heavy bleeding.

Women with kidney disease may also experience disruptions in ovulation or become more sensitive to hormonal fluctuations, particularly as kidney function declines. In advanced stages, anemia and clotting issues may further complicate bleeding patterns.

When to See a Doctor for Abnormal Uterine Bleeding

As you can see, there are many different causes of abnormal uterine bleeding. While your bleeding might be nothing serious, it’s never a good idea to attempt to guess what is causing abnormal bleeding.

It’s better to be safe than sorry. Abnormal uterine bleeding can be a sign of a serious health condition, so it’s important to get it checked out as soon as possible.

If you are a female who is experiencing any type of abnormal bleeding, it is important to see your doctor so that the cause can be found and treated. A pelvic exam allows the doctor to inspect for abnormalities that could be contributing to the abnormal bleeding. With proper diagnosis and treatment, abnormal uterine bleeding can often be managed quickly and successfully.

Your OBGYN will be able to determine the cause and provide you with treatment.

Treatment Options For Abnormal Uterine Bleeding

The treatment for abnormal uterine bleeding depends entirely on the underlying cause. In some cases, no treatment may be needed. For example, if bleeding is related to early pregnancy, it often resolves on its own. If bleeding is caused by birth control pills, your doctor may recommend adjusting the dosage or switching to a different formulation.

However, if abnormal bleeding is tied to a more serious condition—such as infection, disease, a displaced or embedded IUD, or a structural issue like fibroids or polyps—treatment may involve medication or even surgery.

Here are some of the most common treatment options your provider may recommend:

Medications

Several types of medication can help regulate or reduce abnormal uterine bleeding, depending on the root cause and your stage of life.

These include:

  • Hormonal birth control, such as pills, patches, or rings, to stabilize hormone levels and regulate cycles.
  • Progestin-only treatments or hormonal IUDs are beneficial for conditions like adenomyosis, endometriosis, or anovulatory bleeding.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to reduce bleeding and relieve cramping.
  • Antifibrinolytics, which help the blood clot more effectively and are often used to treat heavy menstrual bleeding.
  • GnRH agonists or antagonists are sometimes used for short-term suppression of hormone production in more advanced or complex cases.
  • Hormone Replacement Therapy (HRT) may be recommended for women in perimenopause or postmenopause who are experiencing abnormal bleeding due to declining estrogen and progesterone levels. HRT can help restore hormonal balance, ease bleeding, and relieve other menopausal symptoms when used appropriately.

Surgical Options

If medication isn’t effective or if your condition is more complex, your provider may recommend a procedure to address the root cause.

Common surgical treatments include:

  • Endometrial ablation, which removes the uterine lining
  • Uterine artery embolization, often used for fibroids
  • Hysteroscopy to remove polyps or other abnormalities
  • Myomectomy to remove fibroids while preserving the uterus
  • Hysterectomy, which removes the uterus entirely and is considered a last-resort, permanent solution

Lifestyle Changes

In some cases, changes to your daily habits can support other treatments or help reduce symptoms over time.

These may include:

  • Maintaining a healthy weight
  • Quitting smoking
  • Reducing stress levels
  • Managing underlying conditions like thyroid disorders or insulin resistance

Again, treatment for abnormal uterine bleeding depends on the root cause of your bleeding. If your provider recommends medication or surgery, be sure to discuss the benefits and risks of each option to ensure your plan aligns with your health goals.

Also, keep in mind if you’re planning to get pregnant in the future, that’s also an important factor—some treatments may not be appropriate until after you’ve finished having children.

Frequently Asked Questions About Abnormal Bleeding

How long does a period last?

Regular menstrual periods typically last between 3 to 7 days. If your periods are much shorter or longer, and this is new for you, it may not be normal. Keeping track of your cycle and symptoms can help you determine what is normal for you. If you have questions or concerns about a normal period, contact Cool Springs OBGYN to schedule a consultation.

How do I track my menstrual cycle?

To track your period, mark the first day of bleeding on your calendar. Mark each following day of bleeding until it ends. When your next period begins, mark that date as well. To find your cycle length, count the days from the first day of one period to the first day of the next.

When should I worry about my period?

Contact your healthcare provider if your period becomes irregular or stops. Irregular periods may mean another condition needs attention.

What should I do if I am bleeding during pregnancy?

Light bleeding can happen in early pregnancy. Some women get spotting when the fertilized egg attaches to the womb. This is called implantation bleeding. Bleeding can also happen from hormone changes, changes to the opening of the womb, or if the pregnancy is growing in the wrong place. If you bleed during pregnancy, call your doctor, who can help find out what is happening.

Get Help in Brentwood, Tennessee, for Abnormal Uterine Bleeding

If you are experiencing abnormal uterine bleeding, the team at Cool Springs OBGYN can help. We offer a variety of treatment options that can help to manage abnormal uterine bleeding.

Contact us today to schedule an appointment at 615.690.6600. Dr. Lodge and his dedicated staff have been providing high-quality care to women since 2000.