Can Telemedicine Treat Abnormal Uterine Bleeding (AUB) - Triage?

Audience: pediatric

Abnormal Uterine Bleeding (AUB) means bleeding from the uterus that is different from a normal menstrual period. It can include very heavy bleeding, bleeding between periods, or bleeding that lasts a long time. For children and teens, AUB can be concerning and may affect daily activities. Telemedicine can help by allowing a healthcare provider to ask questions, review symptoms, and decide if urgent care is needed. It can guide families on how to manage mild symptoms at home and when to seek in-person care. However, telemedicine cannot perform physical exams or tests needed to find the exact cause of AUB. If symptoms are severe or if there are signs of serious problems, an in-person visit is necessary. This guide explains how telemedicine can be used for AUB triage, what signs to watch for, and how to prepare for and follow up after a telemedicine visit.

Red flags — go in person / ER

• Bleeding soaking through more than one pad or tampon per hour for several hours — seek emergency care immediately.
• Feeling faint, dizzy, or weak along with bleeding — call emergency services or go to the nearest emergency room.
• Severe abdominal or pelvic pain or fever with bleeding — seek urgent medical evaluation.

What telemedicine can do

• Collecting detailed symptom history and bleeding patterns.
• Providing education about AUB and home care advice.
• Assessing urgency and guiding when to seek in-person or emergency care.
• Answering questions about AUB and treatment options.

What telemedicine cannot do

• Performing physical pelvic exams or ultrasounds.
• Ordering or conducting blood tests or other diagnostic tests.
• Providing emergency treatment for heavy bleeding or severe symptoms.
• Diagnosing the underlying cause of AUB definitively.

What is Abnormal Uterine Bleeding (AUB)?

AUB refers to any bleeding from the uterus that is irregular in amount, timing, or duration compared to a normal menstrual cycle. In children and teens, this can mean very heavy bleeding, bleeding that lasts longer than usual, or bleeding between periods. Causes can vary from hormonal changes to medical conditions. Understanding the pattern of bleeding helps healthcare providers decide the next steps.

How Can Telemedicine Help with AUB?

Telemedicine allows you to talk with a healthcare provider using video, phone, or messaging. For AUB, telemedicine can help by:

This can save time and reduce the need to travel, especially if symptoms are mild.

Limitations of Telemedicine for AUB

Telemedicine cannot replace a physical exam or tests such as blood tests or ultrasound, which are often needed to find the cause of AUB. If bleeding is very heavy, if there are signs of anemia (like weakness or dizziness), or if bleeding is accompanied by severe pain or fever, an in-person visit is necessary. Telemedicine providers may recommend urgent care or emergency services in these cases.

When to Seek Immediate In-Person Care

Certain signs with AUB require urgent medical attention. Seek emergency care if your child has:

These are red flags that need prompt evaluation.

Preparing for a Telemedicine Visit

To get the most out of a telemedicine visit for AUB, prepare by:

This information helps the provider make the best assessment.

After the Telemedicine Visit

Follow the healthcare provider’s advice carefully. This may include:

Keep a record of any changes and communicate with your provider if symptoms worsen.

How to prepare for your tele-visit

• Track bleeding details: start date, duration, amount, color, presence of clots.
• Note any other symptoms such as pain, dizziness, or fever.
• List current medications and any health conditions.
• Find a quiet, private space with good internet connection for the visit.
• Have a device with a camera and microphone ready for video calls.

After your tele-visit

• Follow provider’s instructions on home care and symptom monitoring.
• Schedule in-person visits if recommended by the provider.
• Seek emergency care immediately if red flag symptoms develop.
• Keep a symptom diary to share with healthcare providers during follow-up.
• Contact your provider if symptoms worsen or new symptoms appear.

FAQs

What causes abnormal uterine bleeding in children and teens?

AUB in children and teens is often caused by hormonal changes as the body adjusts to menstruation. Other causes can include infections, bleeding disorders, or less commonly, growths or other medical conditions. A healthcare provider can help determine the cause with proper evaluation.

Can telemedicine provide treatment for AUB?

Telemedicine can provide advice and guidance but usually cannot provide definitive treatment because physical exams and tests are often needed. It is useful for triage and deciding if in-person care is needed.

What should I do if my child has very heavy bleeding?

If bleeding is very heavy — soaking through more than one pad or tampon per hour for several hours — seek emergency medical care immediately. Heavy bleeding can be dangerous and requires prompt treatment.

Is it normal for teens to have irregular periods?

Yes, irregular periods are common in the first few years after menstruation starts. However, very heavy, prolonged, or painful bleeding is not normal and should be evaluated by a healthcare provider.

How can I help my child manage AUB at home?

Encourage rest and hydration, use sanitary pads or tampons as needed, and monitor symptoms closely. Avoid aspirin as it can increase bleeding. Follow any advice given by your healthcare provider during telemedicine or in-person visits.

Sources

1. Abnormal Uterine Bleeding — MedlinePlus, U.S. National Library of Medicine.
2. Menstrual Disorders in Adolescents — American Academy of Pediatrics.
3. Evaluation of Abnormal Uterine Bleeding — Mayo Clinic.
4. Abnormal Uterine Bleeding in Adolescents: Approach to Diagnosis and Management — National Library of Medicine.

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person evaluation, diagnosis, or treatment by a healthcare professional. If you or your child experience severe symptoms or red flags, seek immediate medical care.