Anatomic Causes of Abnormal Uterine Bleeding
There are three main anatomic causes of abnormal uterine bleeding:
Fibroids are benign smooth muscle growths that emanate from the uterus and the surrounding tissues. They are common with 1 in 3 black women having them, and 1 in 4 white women having them. They usually cause no problems, and so we leave them alone. However, when they do cause problems, it is pain, abnormal bleeding or infertility.
- a=subserosal fibroids
- b=intramural fibroids
- c=submucosal fibroid
- d=pedunculated submucosal fibroid
- e=prolapsed fibroid
- f=intraligamenousl fibroid
These emanate from the glandular lining from the uterus, also called the endometrium. Like the endometrium, these are hormonally responsive and bleed along with the period. However, they can become fragile, disorganized and bleed randomly and profusely. It is not unusual for tiny polyps to come and go but anything over a centimeter in size is a concern and should be evaluated.
Cells of the endometrium can become overstimulated, hyperplastic, precancerous or cancerous. Even if there is only a small number of such cells and they are not visible on imagine studies, they can cause abnormal uterine bleeding. We check for them using an endometrial biopsy, or EMB. Click here to learn more.
For notes on the treatment of anatomic causes of abnormal uterine bleeding click here.