Most often, we are referring to bleeding from the uterus, which may be irregular in terms of when it occurs, its intensity, and how long it lasts. There are several causes of bleeding (PALM-COIEN).

Frequently, it involves polyps of the cervix or uterine body, adenomyosis, fibroids, but it can also involve precancerous or cancerous changes in the lining of the uterus.

Bleeding can also be the result of impaired blood clotting (coagulopathy), hormonal fluctuations during ovulation, or can be caused by the lining of the uterus – e.g., in the case of endometritis, or as a result of therapeutic measures, e.g., insertion of Mirena IUD, hormone replacement therapy, and contraception.

In diagnostics, a clinical examination with the aid of speculums (mirrors) is important, which determines the site of bleeding, followed by a thorough transvaginal ultrasound examination.

The causes of bleeding can also be traumatic – injuries to the vagina during intercourse or when inserting foreign objects, but can also be the result of cancerous changes in the cervix.

Treatment

If abnormal uterine bleeding is mild and not bothersome, it can only be monitored. If it is bothersome, it is treated according to the cause of its occurrence.

Hormonal therapy (contraception, Mirena IUD) and other drug therapy are considered here.

Diagnostic hysteroscopy plays an important role in diagnostics and treatment, while in the case of fibroids and adenomyosis, we often decide on a more invasive, hysteroscopic and laparoscopic procedure.