Abnormal uterine bleeding refers to vaginal bleeding that occurs outside a person’s usual menstrual pattern or that is unusually heavy or prolonged. This page provides general information and guidance about which specialists to consult; definitive diagnosis requires clinical evaluation by a gynecologist or other clinician.
The term includes spotting between periods, unexpected or intermenstrual bleeding, menstrual periods that are much heavier or longer than usual, and any vaginal bleeding after menopause. It groups different underlying mechanisms rather than naming a single cause.
Causes span several categories: hormonal changes that affect the menstrual cycle; structural conditions such as polyps, fibroids, or endometrial thickening; pregnancy-related issues (for example miscarriage or ectopic pregnancy); bleeding and clotting disorders; certain medications; and infections. Each category guides different lines of assessment.
Initial assessment is usually with a gynecologist or obstetrician. Evaluation commonly starts with a medical history and pelvic exam. Tests may include pelvic ultrasound, pregnancy test, blood tests (complete blood count, relevant hormone tests), cervical screening, and—when indicated—endometrial sampling. These steps help classify likely causes and determine appropriate referral.
Seek immediate medical attention if bleeding is so heavy that it causes fainting, severe dizziness, shortness of breath, or a very fast heartbeat, or if you need to change large pads or tampons very frequently. Any rapidly worsening bleeding or signs of instability should be evaluated in an emergency setting.
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