Uterine growths sometimes produce a heavy menstrual flow or spotting between periods. PCOS makes periods absent or irregular. Post menopausal vaginal bleeding may be a sign of uterine cancer.
- Heavy bleeding. Heavy bleeding is classified as a 50% increase in normal flow or soaking through more than 10 tampons or sanitary pads in a day. Bleeding that lasts longer than a week is also considered heavy.
- Spotting. Episodes of breakthrough bleeding that occur between regular menstrual periods is called spotting.
- Absent periods. Periods may stop once they have started (called secondary amenorrhea), or they may never begin in the first place (called primary amenorrhea).
- Irregular periods. Getting a short or light period every two to three weeks instead of one monthly period is considered to be irregular. Bleeding after menopause, as well, is irregular and should be investigated right away.
Pregnancy and obesity can contribute to fibroid development, leading to abnormal uterine bleeding.
Fibroids are a major cause of abnormal uterine bleeding in women over the age of 30. One-third of women over the age of 30 have fibroids. Doctors do not know why some women develop fibroids, but these benign tumors appear to be fed by estrogen. Fibroids typically grow during pregnancy, when estrogen levels are high, and shrink after menopause when estrogen levels are low. Obesity also contributes to fibroid development, perhaps because fat cells produce estrogen.
Having a family member with polycystic ovary syndrome puts you at risk for the condition, and thus at risk for abnormal uterine bleeding. Polycystic ovary syndrome (PCOS) affects between 5% and 10% of women during their reproductive years. The cause of PCOS is unknown, but it seems to run in families. Symptoms often occur during puberty right around the time that periods normally start. Weight gain, acne, and male-pattern body hair are other symptoms of PCOS. If left untreated, the condition can result in infertility and lead to uterine cancer later in life.
Obesity, hypertension, diabetes, PCOS, and late menopause are all associated with an increased risk of uterine cancer, and therefore abnormal uterine bleeding. Uterine cancer usually strikes women after menopause.
The disease also occurs with higher frequency in postmenopausal women who have used unopposed estrogen therapy on a long-term basis. It occurs with less frequency in those who have used oral contraceptives. The cancer tends to be more common in women who have had few or no children.
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