What could possibly cause such a horrible period?

That’s an important question to get answered.

When you know the source–the root cause of your heavy periods–you can confidently choose a treatment pathway that supports you.

Things can be scary when you're in the dark

Things can be scary when you're in the dark

When it’s not just a period

Despite all the pain and suffering it causes, you’ll be relieved to know that Abnormal Uterine Bleeding is rarely a sign of cancer for premenopausal women.1

These are the most common causes of AUB in women of reproductive age:

What are endometrial causes?

If you have heavy menstrual bleeding with regular menstrual cycles and no other causes can be identified, you may be diagnosed with Endometrial dysfunction, or AUB-E.

This diagnosis suggests there are irregularities in hormone levels during the shedding and repairing of the Endometrium, which can lead to endometrial tissue that is thicker than normal, resulting in a heavy and long period, often with large blood clots.

AUB-E is an exclusion diagnosis. Meaning, fibroids and polyps (and other common causes) have been ruled out as the cause of AUB.

Signs and symptoms of AUB-E

Heavy menstrual bleeding

Periods with clots

Long periods (7+ days)

Bleeding between periods

Learn about the minimally invasive, safe and effective treatment of AUB-E

Meet Minerva ES

What are fibroids?

Fibroids are dense growths and can be within the walls of the uterus, outside the uterine cavity, or protrude into the uterine cavity. They are muscle and fibrous connective tissue and are generally smooth and rounded in appearance.

Did you know?

Did You Know...

By age 50, more than 80% of Black women and nearly 70% of White women will experience fibroids.1

You may have a single fibroid that is tiny and have no symptoms. Or you may have a big fibroid that is larger than your actual uterus and have pain in your back and legs. You can even have clusters of them.

And they’re not soft. They can be hard like a baseball or golf ball. Consider the size of your uterus (approximately 3” x 2” x 1”) and its location (nested next to your colon and intestines and on top of your bladder) and now you can imagine how fibroids cause so many problems.

Those intense cramps and aches are not your imagination.

Types of fibroids

Signs and symptoms of fibroids

Heavy menstrual bleeding

Menstrual periods lasting more than a week

Pelvic pressure or pain

Frequent urination

Difficulty emptying the bladder

Constipation

Backache or leg pains

Infertility

Frequent, unpredictable periods

According to the American Journal of Obstetrics and Gynecology:2

Women wait an average of 3.6 years before seeking treatment for fibroids

%saw 2 or more healthcare providers for diagnosis
%reported missing work due to symptoms
%believed symptoms hindered their career

Women expressed a desire for:

treatments that do not involve invasive surgery%
treatments that preserve the uterus%
treatments that preserve fertility%
(under 40 years of age)

Good news. Living fibroid-free is no fantasy.

Meet Symphion

A breakthrough in the treatment of fibroids.

What are uterine polyps?

Uterine polyps are composed of endometrial cells and grow in response to circulating estrogen. They form on the lining of the uterine cavity and are attached to the uterine wall by a large base or a thin stalk. While they usually remain inside your uterus, they can sometimes be found in your cervical canal, vagina or blocking your fallopian tubes.

They range in size from a few millimeters—no larger than a sesame seed—to several centimeters—golf-ball-size or larger.

(Remember your uterus is approximately 3” x 2” x 1”)

Signs and symptoms of uterine polyps include

Irregular menstrual bleeding — for example, having frequent, unpredictable periods of variable length and heaviness

Bleeding between menstrual periods

Excessively heavy menstrual bleeding

Vaginal bleeding after menopause

Infertility

Signs and symptoms of uterine polyps include

Polyps can be removed using fast, safe, minimally-invasive, in-office treatments

Meet Resectr

You deserve to be heard

A consultation with a gynecologist who understands AUB is what you need and deserve.

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AUB Causes FAQs

What are fibroids?

Fibroids are muscular non-cancerous growths, or tumors in the walls or within the cavity of the uterus. Another medical term for fibroids is leiomyoma or "myoma". Doctors believe fibroids can interfere with implantation of the fertilized egg and the ability to carry a pregnancy to term.

Are fibroids cancerous?

Rarely (less than one in 1,000*) will a fibroid be cancerous. This is called leiomyosarcoma. Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.*

*https://www.mayoclinic.org/diseases-conditions/ uterine-fibroids/symptoms-causes/syc-20354288#:~:text=Uterine %20fibroids%20are%20noncancerous%20growths,almost%20never%20 develop%20into%20cancer.

What causes fibroids?

No one knows, and we need more research. But existing research does point to fibroids being affected by both estrogen and progesterone (naturally occurring hormones) levels. If your female relatives have fibroids, you are likely to have them as well.

What are symptoms of fibroids?

  • Heavy menstrual bleeding
  • Menstrual periods lasting more than 7 days
  • Pelvic pressure or pain
  • Feeling full or bloated
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains
  • Irregular menstrual bleeding, or having frequent, unpredictable periods of variable length and heaviness

Click here to learn more about fibroids.

What are polyps?

Polyps are composed of endometrial cells, whereas fibroids are composed of muscle cells. That means polyps are less dense than fibroids. They grow in the uterine cavity and can also be found in the cervix and vagina. As with fibroids, doctors believe polyps can interfere with implantation of the fertilized egg and the ability to carry a pregnancy to term.

What causes polyps?

There is no definitive data on what causes polyps to form.

What are the symptoms of polyps?

  • Irregular menstrual bleeding, or having frequent, unpredictable periods of variable length and heaviness
  • Bleeding between menstrual periods
  • Excessively heavy menstrual periods
  • Bleeding after sex
  • Vaginal bleeding after menopause
  • Infertility

Do fibroids grow over time?

Fibroids do grow overtime, and they can also shrink and go through growth spurts.

They stop growing after a woman goes through menopause.

Do fibroids go away on their own?

Fibroids can shrink and disappear. No one knows why they go through growth spurts or vanish, but doctors do know that fibroids are impacted by hormones, so their growth patterns may be hormone-related.

How do I know if I have fibroids and/or polyps?

Occasionally fibroids can be discovered during a routine pelvic exam. But in order to definitively diagnose fibroids or polyps, you’ll need to undergo a hysteroscopy, ultrasound or MRI. A Symphion hysteroscopy will enable your physician to clearly see inside your uterus and quickly and safely remove fibroids and polyps in one treatment.

Click here to learn more about Symphion.

Does my doctor need to look inside my uterus to determine the cause of AUB?

Yes, your doctor will want to see inside of your uterus to clearly see any pathology (fibroids, polyps) present in the uterine cavity and possibly conduct an endometrial biopsy to help determine the diagnosis before treatment. You may also receive an ultrasound or MRI, but the most consistently accurate way of identifying pathology in the uterine cavity is with a hysteroscope.

Click here for more information on diagnosing AUB.

Are fibroids and polyps genetic?

Often women in the same family experience fibroids and polyps, but there is no data that indicates fibroids and polyps are hereditary.

I don’t have fibroids or polyps, so why are my periods so heavy?

AUB may be caused by many medical conditions. The heavy periods you are experiencing may be related to Abnormal Uterine Bleeding-Endometrial Dysfunction(AUB-E), or AUB caused by a thickening of the endometrium.

You can find more information about that here.

Can any doctor remove fibroids?

All gynecologists are trained to remove fibroids. Some gynecologists specialize in minimally invasive treatments for fibroid removal.

How do polyps affect fertility?

It is largely unknown if or how polyps contribute to infertility issues. Some physicians believe polyps interfere with fertility by preventing a fertilized egg from implanting in the uterine wall correctly, but more research needs to be conducted.

Click here for more information on how AUB affects fertility.

How do fibroids affect fertility?

Fibroids can affect the number of sperm that can enter the uterus and inhibit their movement or the transport of a fertilized egg in the uterus. Fibroids can block the fallopian tubes, and they can alter the lining of the uterine cavity, affecting the fertilized egg's ability to implant in the lining. Fibroids can also affect blood flow to the uterine cavity, decreasing the ability of the fertilized egg's to implant to the uterine wall or develop properly.

Click here for more information on how AUB affects fertility.

Can fibroids or polyps cause a miscarriage?

Yes, fibroids and polyps can also affect whether an embryo can implant properly, which is necessary for a sustained pregnancy. Fibroids can also affect the growth and positioning of the baby, which can result in a preterm delivery (<37 weeks), a breech presentation and the need for a cesarean section, and low birth weight*.

*Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix.
Blitz MJ, Rochelson B, Augustine S, Greenberg M, Sison CP, Vohra N
J Matern Fetal Neonatal Med. 2016 Nov; 29(21):3454-60.

I have an appointment with a gynecologist. What questions should I be asking about my periods?

Download this AUB physician discussion guide. You’ll have everything you need in one place to have an informative conversation about AUB, and you’ll be prepared with questions to ask your healthcare team.