Dysfunctional Uterine Bleeding

What Is It?

Dysfunctional uterine bleeding, also called anovulatory bleeding, is any bleeding from the vagina that varies from a woman's normal menstrual cycle. The normal cycle is triggered by signals from hormones. Dysfunctional uterine bleeding occurs when the cycle's hormonal signals get thrown off. This can include alternating periods that are heavy and light, spotting or unpredictable shorter and longer cycles.

Regular monthly menstrual cycles flush out the endometrial lining, which is the blood-enriched layer of tissue that grows inside the uterus every month in anticipation of a possible pregnancy.

If ovulation does not occur, periods can be delayed, which allows the endometrial lining to grow thicker. For that reason, delayed periods are often heavy ones.

Lighter periods, or spotting between periods, may represent an endometrial lining that is unstable and leaking, either because hormonal levels don't adequately support it or because the lining may be too thick.

Other factors that can change bleeding patterns include:

• Certain hormonal abnormalities (thyroid problems, hyperprolactinemia)

• Medications

• Excessive exercise or weight loss

• Obesity

• Stress or illness

• The start of menstruation in adolescence - Regular ovulatory cycles may not develop for a few months or even years.

• The end of menstruation - Dysfunctional uterine bleeding is common in the months to years before menopause.

Symptoms

Irregular bleeding can come at different times from month to month and last for different amounts of time. The amount of flow may vary from light to extremely heavy with large clots. In some patients the bleeding may be associated with uterine cramps.