What are the common causes of abnormal uterine bleeding?
Jul 17, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
In general, abnormal uterine bleeding may be caused by factors such as ovulation period bleeding, the initial period after insertion of an intrauterine contraceptive device, endometritis, endometrial polyps, or uterine fibroids. It is recommended to seek timely medical attention to determine the exact cause, followed by symptomatic treatment under a doctor's guidance. In daily life, it is important to maintain good living habits, avoid staying up late and mental stress, and pay attention to menstrual hygiene.
Generally, abnormal uterine bleeding may be caused by factors such as ovulatory bleeding, early phase after intrauterine device placement, endometritis, endometrial polyps, and uterine fibroids. It is recommended to seek timely medical attention to identify the underlying cause and receive appropriate treatment under a doctor's guidance. Detailed analysis is as follows:
1. Ovulatory bleeding: During ovulation, a temporary decline in estrogen levels causes slight shedding of the endometrium, resulting in light bleeding that lasts 1-3 days. This is a normal physiological phenomenon. Adequate rest, avoiding fatigue, and maintaining external genital hygiene are recommended. No specific treatment is required; simply observe whether the bleeding recurs in a cyclical pattern.
2. Early phase after intrauterine device placement: The device may irritate the endometrium, causing local injury or inflammatory reaction, which could lead to abnormal bleeding within the first 3-6 months, often accompanied by mild abdominal pain. Maintaining a regular lifestyle and avoiding strenuous exercise are advised. If bleeding persists, tranexamic acid tablets or Yunnan Baiyao capsules may be used under a doctor's guidance to reduce bleeding. If necessary, the device may be removed and an alternative contraceptive method adopted.
3. Endometritis: Bacterial infection causes inflammation of the endometrium, leading to congestion, edema, and easy bleeding. This is often accompanied by lower abdominal pain, increased vaginal discharge with an unpleasant odor. Patients should follow medical advice to take antibiotics such as cefixime capsules, metronidazole tablets, and azithromycin dispersible tablets. Bleeding stops after the inflammation subsides. Sexual activity should be avoided during treatment, and personal hygiene should be maintained.
4. Endometrial polyps: Localized excessive endometrial growth forms polyps, which are fragile and prone to bleeding, manifesting as prolonged menstruation or intermenstrual bleeding. Small polyps can be monitored regularly. Patients may take progesterone soft capsules or dydrogesterone tablets as directed to regulate hormone levels. Larger or symptomatic polyps require hysteroscopic polypectomy to remove the polyps and stop the bleeding.
5. Uterine fibroids: Fibroids increase the surface area of the endometrium or interfere with uterine contractions, resulting in increased menstrual flow and prolonged periods. Larger fibroids may cause irregular bleeding. Patients may take tranexamic acid tablets, mifepristone tablets, or Guizhi Fuling capsules as directed to alleviate bleeding. Surgery (myomectomy) may be required for large fibroids to remove them and improve bleeding symptoms.
Maintain healthy lifestyle habits in daily life, avoid staying up late and mental stress, and pay attention to menstrual hygiene. If abnormal bleeding occurs, record the time, amount, and any associated symptoms to help the doctor identify the cause and provide targeted treatment, thus maintaining reproductive health.
