Usually, no causative abnormality can be identified and treatment is directed at the symptom, rather than a specific mechanism. However, there are known causes of abnormal uterine bleeding that need to be ruled out. Most common causes based on the nature of bleeding is listed below followed by the rare causes of bleeding (i.e. disorders of coagulation). Consideration * Excessive menses but normal cycle: * Painless: * Fibroids (leiomyoma) — fibroids in the wall of the uterus cause increased<unk>  loss if they protrude into the central cavity and thereby increase endometrial surface area. * Coagulation defects (rare) — with the shedding of an endometrial lining's blood vessels, normal coagulation process must occur to limit and eventually stop the blood flow. Blood disorders of platelets (such as ITP) or coagulation (such as von Willebrand disease) or use of anticoagulant medication (such as warfarin) are therefore possible causes, although a rare minority of cases. Platelet function studies can also be used to ascertain platelet function abnormalities * Endometrial cancer (cancer of the uterine lining) — bleeding can also be irregular, in between periods, or after the menopause (post-menopausal bleeding or PMB) * Endometrial polyp * Painful (ie associated with dysmenorrhea): * Pelvic inflammatory disease * Endometriosis - extension of the endometrial tissue outside of the uterus tries to shed causing painful and abnormal bleeds * Adenomyosis - extension of the endometrial tissue into the wall of the uterus tries to shed causing painful and abnormal bleeds * Pregnancy related complication (i.e. miscarriage) * Short cycle (less than 21 days) but normal menses. * Short cycle and excessive menses due to ovarian dysfunction and may be secondary to blockage of blood vessels by tumours. * Polycystic ovary syndrome. * Systemic causes: thyroid disease, excessive emotional/physical stress. * Sexually transmitted infection. Omega 6 and prostaglandins<unk>  is associated with increased omega-6 AA in uterine tissues. The endometrium of women with<unk>  have higher levels of prostaglandin (E2, F2alpha and others) when compared with women with normal menses. It is thought that prostaglandins are a by product of omega 6 build up.
Heavy menstrual bleeding
Irregular menstruation
Intermenstrual bleeding
Abnormal uterine bleeding
Vaginal bleeding
Frequent urination
Abdominal aura
Urethrorrhagia