Red flags & when to go in person for Abnormal Uterine Bleeding (AUB) - Triage

Audience: adult

Abnormal Uterine Bleeding (AUB) means having unusual bleeding from the uterus that is different from your normal menstrual cycle. It can include very heavy bleeding, bleeding between periods, or bleeding after menopause. While many causes of AUB are not serious, some signs mean you should seek in-person care quickly. These include very heavy bleeding soaking through pads or tampons in an hour, feeling dizzy or faint, or severe pain. Telemedicine can help assess your symptoms, provide information, and guide you on next steps. However, some situations require physical exams, tests, or treatments that can only be done in person. This guide helps you understand when to use telemedicine and when to go for urgent in-person care. Remember, this is educational information and not a diagnosis. If you have concerns about your bleeding, talk to a healthcare provider.

Red flags — go in person / ER

• Soaking through one or more pads or tampons every hour for several hours — seek emergency care immediately.
• Feeling faint, dizzy, or weak along with bleeding — go to urgent care or emergency room.
• Severe lower abdominal or pelvic pain with bleeding — get prompt medical evaluation.

What telemedicine can do

• Reviewing symptoms and medical history related to AUB.
• Providing education about possible causes and management.
• Advising when to seek urgent or in-person care.
• Scheduling follow-up appointments or tests.

What telemedicine cannot do

• Performing physical pelvic exams or ultrasounds.
• Conducting laboratory tests such as blood counts or hormone levels.
• Providing emergency treatment for heavy bleeding or severe pain.
• Diagnosing serious underlying conditions requiring in-person assessment.

What is Abnormal Uterine Bleeding (AUB)?

AUB refers to bleeding from the uterus that is irregular in timing, amount, or duration compared to your usual menstrual pattern. It can happen at any age and may include heavy periods, spotting between periods, or bleeding after menopause. Causes vary from hormonal changes to infections or other health conditions.

When to Seek In-Person Care Immediately

Certain symptoms with AUB need urgent medical attention. These include:

If you experience any of these, go to an emergency room or urgent care center.

How Telemedicine Can Help

Telemedicine allows you to talk with a healthcare provider remotely. For AUB, telemedicine can:

However, it cannot replace physical exams or certain tests.

Preparing for Your Telemedicine Visit

To get the most from your tele-visit:

How to prepare for your tele-visit

• Track your bleeding details: start date, amount, duration, and any clots.
• Note any additional symptoms like pain, dizziness, or fever.
• List current medications and any health conditions.
• Prepare questions or concerns you want to discuss.
• Ensure a private, quiet space with reliable internet or phone connection for the visit.

After your tele-visit

• Follow the healthcare provider's advice regarding symptom management.
• Schedule any recommended in-person tests or exams.
• Monitor your symptoms and seek immediate care if red flags appear.
• Keep a record of your bleeding and symptoms for future visits.
• Contact your provider if symptoms worsen or new symptoms develop.

FAQs

What causes abnormal uterine bleeding?

AUB can be caused by hormonal imbalances, uterine fibroids, polyps, infections, bleeding disorders, or other health conditions. Sometimes, the exact cause is not clear without further tests.

Is abnormal uterine bleeding dangerous?

Many causes of AUB are not serious, but heavy bleeding can lead to anemia or indicate more serious conditions. It's important to watch for red flags and seek care when needed.

Can I treat abnormal uterine bleeding at home?

Mild symptoms may be managed with rest and over-the-counter pain relievers. However, you should consult a healthcare provider to understand the cause and get proper advice.

When should I go to the emergency room for AUB?

Go to the emergency room if you are soaking through pads or tampons every hour for several hours, feel faint or dizzy, have severe pain, or pass large clots or tissue.

Can telemedicine replace in-person visits for AUB?

Telemedicine is useful for initial assessment and guidance but cannot replace physical exams or tests needed for diagnosis and treatment of AUB.

Sources

1. Abnormal Uterine Bleeding — MedlinePlus, U.S. National Library of Medicine.
2. Abnormal Uterine Bleeding in Reproductive-Age Women: A Clinical Review — National Library of Medicine.
3. Heavy Menstrual Bleeding — Centers for Disease Control and Prevention (CDC).
4. Abnormal Uterine Bleeding: Causes and Diagnosis — Mayo Clinic.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical evaluation, diagnosis, or treatment. If you experience any red flags or worsening symptoms, seek urgent medical care promptly.