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

Audience: pediatric

Abnormal Uterine Bleeding (AUB) means bleeding from the uterus that is different from the usual menstrual cycle. In children and teens, AUB can cause worry and discomfort. It may happen because of hormonal changes, infections, or other health issues. Telemedicine can help you understand symptoms and decide if you need to see a healthcare provider in person. Some signs, like very heavy bleeding, severe pain, or feeling very weak, need urgent care. This guide helps you know when to seek in-person help and what to expect during telemedicine visits. Remember, this information is for education only and not a diagnosis. Always reach out to a healthcare professional if you are concerned about bleeding or other symptoms.

Red flags — go in person / ER

• Bleeding soaking through one or more pads or tampons every hour for two hours or more — go to emergency care immediately.
• Severe abdominal or pelvic pain that does not improve — seek urgent in-person evaluation.
• Feeling dizzy, faint, or very weak with bleeding — get emergency medical attention right away.

What telemedicine can do

• Initial symptom assessment and history taking
• Providing education about AUB and menstrual health
• Guidance on when to seek in-person care
• Follow-up on mild symptoms or treatment adherence

What telemedicine cannot do

• Emergency situations with heavy bleeding or severe pain
• Physical examination or pelvic ultrasound
• Blood tests or other diagnostic procedures
• Immediate treatment of severe anemia or infection

What is Abnormal Uterine Bleeding (AUB)?

AUB means bleeding from the uterus that is different from normal periods. It can be heavier or lighter, last longer or shorter, or happen at unexpected times. In children and teens, AUB often relates to changes in hormones as the body grows. Sometimes, it may signal an infection or other health problems.

Common Causes of AUB in Pediatric Patients

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Understanding the cause helps guide treatment and when to seek care.

When to Use Telemedicine for AUB

Telemedicine can help you:

It is a safe way to start care without leaving home.

When to Go In Person for AUB

Seek in-person care if you or your child experience:

These signs need timely evaluation and treatment.

Preparing for a Telemedicine Visit

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This information helps your healthcare provider understand the situation better.

After the Telemedicine Visit

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Good communication helps manage AUB effectively.

How to prepare for your tele-visit

• Write down when bleeding started and how long it lasts
• Count how many pads or tampons are used daily
• Note any pain or other symptoms like fever or dizziness
• List current medications and supplements
• Prepare questions or concerns to discuss
• Ensure a private, quiet place for the tele-visit
• Have a phone or device with good internet connection ready

After your tele-visit

• Follow healthcare provider’s advice or prescriptions
• Schedule in-person visits if recommended
• Monitor bleeding and symptoms daily
• Seek emergency care if red flags develop
• Keep a diary of bleeding patterns and symptoms for follow-up

FAQs

What counts as heavy bleeding in AUB?

Heavy bleeding often means soaking through one or more pads or tampons every hour for several hours. It can also mean passing large blood clots or needing to change protection during the night.

Can stress cause abnormal uterine bleeding?

Yes, stress can affect hormones and sometimes cause changes in menstrual bleeding patterns, especially in teens.

Is it normal to have irregular periods during puberty?

Yes, during puberty, hormone levels fluctuate and periods may be irregular for several years before becoming regular.

When should I worry about AUB in my child?

You should seek care if bleeding is very heavy, lasts more than two weeks, is accompanied by severe pain, dizziness, or fever, or if your child feels very weak.

Can telemedicine replace all visits for AUB?

Telemedicine is helpful for initial advice and follow-up but cannot replace physical exams, tests, or emergency care needed for serious symptoms.

Sources

1. Abnormal Uterine Bleeding — MedlinePlus, U.S. National Library of Medicine.
2. Menstrual Disorders in Adolescents — American Academy of Pediatrics.
3. Abnormal Uterine Bleeding: Diagnosis and Management — Centers for Disease Control and Prevention (CDC).
4. Abnormal Uterine Bleeding in Adolescents — Mayo Clinic.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you or your child experience any red flags or worsening symptoms, seek immediate medical attention.