Gynecological Conditions

Abnormal Uterine Bleeding

Abnormal Uterine Bleeding (AUB) refers to any bleeding from the uterus that is longer, heavier, or occurs at irregular intervals compared to normal menstrual periods. Dr. Rashmi Bastakoti, Nepal's leading gynecologist with 25+ years of experience, specializes in comprehensive AUB diagnosis and treatment at GyneNepal, Kathmandu. AUB affects 10-30% of reproductive-age women and can significantly impact quality of life. Dr. Rashmi's systematic approach uses the PALM-COEIN classification to identify causes: Polyp, Adenomyosis, Leiomyoma, Malignancy, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not classified. She has successfully treated over 4,000 AUB cases using medical management, minimally invasive procedures, and surgery when needed. Comprehensive evaluation prevents misdiagnosis and ensures appropriate treatment.

Warning Signs & Symptoms

⚠️Heavy menstrual bleeding (>80ml per cycle)
⚠️Bleeding between periods (intermenstrual bleeding)
⚠️Prolonged periods (>7 days)
⚠️Irregular menstrual cycles
⚠️Bleeding after menopause (postmenopausal bleeding)
⚠️Spotting after intercourse
⚠️Passing large blood clots
⚠️Severe anemia symptoms (fatigue, weakness)
⚠️Flooding requiring frequent pad changes
⚠️Bleeding requiring double protection

Common Causes

🔍Hormonal imbalances (anovulation, PCOS)
🔍Uterine fibroids (leiomyomas)
🔍Endometrial or cervical polyps
🔍Endometriosis and adenomyosis
🔍Bleeding disorders (von Willebrand disease)
🔍Thyroid disorders (hypo/hyperthyroidism)
🔍Medications (anticoagulants, IUDs)
🔍Endometrial hyperplasia or cancer
🔍Pregnancy complications
🔍Pelvic inflammatory disease

Diagnostic Tests

Detailed menstrual history and bleeding diary
Pelvic examination
Transvaginal ultrasound
Endometrial biopsy (women >45 or risk factors)
Hysteroscopy with directed biopsy
Complete blood count (check anemia)
Coagulation studies (PT, PTT, vWF)
Thyroid function tests
Pregnancy test
Pap smear

Treatment Options

💊Medical management: Tranexamic acid (reduces bleeding 40-50%)
💊Hormonal therapy: Combined oral contraceptives
💊Levonorgestrel IUD (Mirena) - first-line treatment
💊NSAIDs for pain and bleeding reduction
💊GnRH agonists for temporary suppression
💊Endometrial ablation (destroys uterine lining)
💊Hysteroscopic polypectomy or myomectomy
💊Uterine artery embolization
💊Hysterectomy for refractory cases
💊Iron supplementation for anemia

Recommended Specialist

Dr Rashmi Bastakoti

Dr Rashmi Bastakoti

MBBS, MD (Obs & Gyne), Fellowship in Reproductive Medicine (Nepal)

25 years
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Contact Information

📞
Phone
+977 9700682797
📧
Email
info@gynenepal.com
📍
Location
Dillibazar Pipalbot, Kathmandu
Hours
Mon-Sat: 8 AM - 6 PM