Abnormal Uterine Bleeding: Causes, Diagnosis & Treatment

Abnormal Uterine Bleeding: When Aunt Flo Doesn’t Stick to the Schedule

Let’s talk about it: bleeding that shows up uninvited, overstays its welcome, or throws your whole cycle into chaos. Abnormal uterine bleeding (AUB) is like that guest who eats all your snacks and then spills red wine on the carpet. Not cute.

Whether your period has turned into a non-stop marathon or ghosted you completely, you’re not imagining things—and you’re definitely not alone.

So, What Is Abnormal Uterine Bleeding?

AUB is any bleeding from your uterus that doesn’t follow the “typical” menstrual pattern. That includes:

Bleeding between periods
Periods that are too frequent (less than 21 days apart) or MIA (more than 35 days apart)
Super heavy periods that soak through pads or tampons every hour
Periods that last longer than 7 days
Bleeding after sex or post-menopause

Basically, if your period has gone rogue, it falls under AUB.

Common Causes (a.k.a. The Usual Suspects)

Hormonal Imbalances

Teenagers, postpartum folks, people nearing menopause—this one’s for you. Your estrogen and progesterone levels may be doing the cha-cha, causing your lining to build up and shed unpredictably.

Uterine Fibroids or Polyps

Non-cancerous growths that crash the party and cause heavy bleeding, clots, and pressure.

Birth Control

Starting, stopping, or switching hormonal contraception can confuse your cycle. Some IUDs and pills cause spotting—sometimes a lot of it.

Pregnancy (and Complications)

Spotting can happen in early pregnancy, but heavy bleeding can signal miscarriage or ectopic pregnancy. Always call your doctor.

PCOS (Polycystic Ovary Syndrome)

Hormonal imbalance, irregular ovulation, acne, and facial hair? Welcome to PCOS—AUB is just one of its calling cards.

Thyroid Disorders

Your thyroid helps regulate your cycle. If it’s under- or over-performing, your period might get weird.

Cancer or Precancer

Rare, but important—especially if you’re bleeding after menopause.

How Is AUB Diagnosed?

Cue the detective work:

Pelvic exam
Blood tests (hormone levels, thyroid function)
Pap smear
Ultrasound
Endometrial biopsy (if needed)

Getting a diagnosis is the first step to reclaiming your cycle (and your sanity).

Treatment Options That Don’t Involve Suffering in Silence

Hormonal Therapy

Birth control pills, hormonal IUDs, or other meds to balance out the estrogen-progesterone situation.

Lifestyle Changes

Stress less (we know, easier said than done), manage weight, and try anti-inflammatory diets. Your uterus likes stability.

Surgery

If fibroids or polyps are causing chaos, procedures like a myomectomy or endometrial ablation might be recommended.

Iron Supplements

Because losing lots of blood can tank your iron levels—and your energy.

Regular Monitoring

Sometimes just keeping track with apps and follow-ups does the trick, especially if your hormones are still settling.

When to Call Your Gyno (a.k.a. Don’t Wait It Out)

Reach out if:

You’re bleeding through a pad/tampon every hour
You’re passing clots bigger than a quarter
You’re feeling dizzy, weak, or anemic
You’ve hit menopause and started bleeding again
Your cycle has been irregular for more than 3 months

Your Period, Your Rules

Listen, your period doesn’t need to be perfect—but it should be predictable and manageable. If your cycle has turned into a circus act, we’re here to help you bring back the calm.

Abnormal uterine bleeding isn’t something to brush off or power through. Your body is trying to tell you something—and we’re ready to listen.

Please book an appointment with Dr. Kameelah Phillips today at Calla Women's Health, the leading female menopause specialist in NYC and let’s get your period back on track. Your uterus deserves peace.

Dr. Kameelah Phillips is affiliated with Lenox Hill Hospital in Manhattan, New York, As a NAMS Certified Menopause Practitioner (NCMP), she focuses on patient care throughout all life stages, specializing in menopause and midlife healthcare.