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What conditions cause abnormal vaginal bleeding in women who are ovulating regularly?
What conditions cause abnormal vaginal bleeding in women who are ovulating regularly?

Abnormal vaginal bleeding in women who are ovulating regularly, most commonly involve excessive, frequent, irregular, or decreased bleeding. Some of the common conditions that produce each of these symptoms are discussed below.
Excessively heavy menstrual bleeding (menorrhagia)
Excessively heavy menstrual bleeding, called menorrhagia, is menstrual bleeding of greater than about eight tablespoons per month (normal menstrual bleeding produces between two and eight tablespoons per cycle). The most common pattern of menorrhagia is excessive bleeding that occurs in regular menstrual cycles and with normal ovulation.
There are several important reasons that menorrhagia should be evaluated by a doctor. First, menorrhagia can cause a woman substantial emotional distress and physical symptoms, such as severe cramping. Second, the blood loss can be so severe that it causes a dangerously lowered blood count (anemia), which can lead to medical complications and symptoms such as dizziness and fainting. Third, there can be dangerous causes of menorrhagia that require more urgent treatment.
Benign (noncancerous) causes of menorrhagia include:
uterine fibroids (benign tumors of smooth muscle tissue),
endometrial polyps (tiny benign growths that protrude into the womb),
adenomyosis (the presence of uterine lining tissue within the muscular wall of the uterus),
intrauterine devices (IUD’s),
underactive thyroid function (hypothyroidism),
an autoimmune disorder systemic lupus erythematosus,
blood clotting disorders such as inherited bleeding disorders, and
certain medications, especially those that interfere with blood clotting.
Though not common, menorrhagia can be a sign of endometrial cancer. A potentially precancerous condition known as endometrial hyperplasia can also result in abnormal vaginal bleeding. This situation is more frequent in women who are over the age of 40.
Although there are many causes of menorrhagia, in most women, the specific cause of menorrhagia is not found even after a full medical evaluation. These women are said to have dysfunctional uterine bleeding. Although no specific cause of the abnormal vaginal bleeding is found in women with dysfunctional uterine bleeding, there are treatments available to reduce the severity of the condition.

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