Menstruation is a cyclical physiological phenomenon starting from menarche till menopause.

A menstrual cycle begins from the first day of one period to the first day of the next period.  It ranges between ranges between 21-35 days and the bleeding may last for 3 to 7 days. The number of pads/tampons changed, and the presence of clots can assess volume of blood flow.

Abnormal uterine bleeding is when if

  • There are irregular cycles for more than 35 days, or less than 21 days
  • Heavy menstrual flow for more than 7 days, with clots.
  • Bleeding in between periods
  • Bleeding after intercourse
  • Bleeding after menopause

Incidence: It can occur in any age. It is most common during the early years of menarche, up to 16 years, and during the premenopausal period.


  1. Organic
    When there is an organic pathology of the uterus and cervix, ovaries or tubes.Pregnancy and related conditions:

  2. Dysfunctional bleeding
    A condition when no organic pathology is found

    • Altered hypothalamo-pituitary axis
    • Altered estrogen and progesterone production

When a patient comes to the outpatient with any abnormal bleeding, a thorough general physical examination is done and a vaginal examination done to rule out any abnormality of the uterus and cervix.

Routine blood investigations done and a transvaginal ultrasound. After preliminary investigations, a few higher investigations might be necessary for conclusion of the diagnosis, like a saline sonogram, endometrial sampling, and a diagnostic hysteroscopy.


  • Treatment of anaemia
  • Lifestyle modification, weight reduction with diet and exercise.

Definitive treatment

  • Nonhormonal and hormonal medications
  • Surgery => endometrial ablation, hysterectomy.

For further assistance, book an appointment with the best Obstetrician & Gynecologist in India at Ask Apollo.

Contributed By:

Dr. V. Senthamil Senthil, MBBS, DNB (OBGYN)
Consultant Obstetrician & Gynaecologist
Apollo Hospitals, Greams Road, Chennai

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