How Abnormal Bleeding Raises Fertility Concerns
Menstruation is a predictable part of life for most women, yet when bleeding occurs outside the cycle, it raises troubling questions.
Known medically as abnormal uterine bleeding (AUB), this condition is increasingly flagged by Nigerian gynaecologists as a silent but serious threat to reproductive health.
From unexplained spotting to prolonged heavy flows, AUB is not only distressing but can also complicate fertility.
In clinics across Lagos, Abuja, and other urban centres, women are seeking answers, often unaware that irregular bleeding may point to underlying conditions requiring urgent medical evaluation.
Main Causes Of The Bleeding
Understanding why abnormal bleeding occurs is key to demystifying the experience and accessing the right care.
Here are a few known culprits: Cervical Abnormalities: Conditions like cervical fibroids or infections such as HPV can cause light, irregular bleeding. In rare instances, cervical cancer may also be responsible, underscoring the need for routine cervical screenings (like Pap smears), which remain underutilised in many parts of Nigeria.
Endometriosis: Affecting women globally, including many here in Nigeria, endometriosis involves tissue similar to the womb lining growing outside the uterus. This disrupts hormonal signalling and often causes pain and mid-cycle bleeding.
Implantation Bleeding:
Light spotting six to twelve days after ovulation may signal early pregnancy. For up to a third of women who conceive, this subtle sign goes unnoticed or is mistaken for an early period.
Ruptured Ovarian Cyst: In some cases, women report sudden abdominal pain on one side, followed by spotting. This could point to an ovarian cyst rupture—an event that may affect ovulation and in turn, fertility.
Managing AUB
Medical management is the first line of defence for most AUB cases. Nigerian gynaecologists frequently prescribe hormonal treatments such as oral contraceptives, progesterone tablets, or oestrogen-based therapies to help stabilise the menstrual cycle.
In more severe cases, especially where there is significant blood loss or suspected pathology, further diagnostic steps such as pelvic scans, blood tests, or even surgical intervention may be recommended.
Is Pregnancy Possible With AUB?
Yes, but it is complicated. AUB can disrupt ovulation patterns, making it harder to identify fertile windows. Women undergoing assisted reproductive techniques like IVF may also face additional hurdles if the bleeding isn’t brought under control.
With fertility struggles already a major concern in Nigeria, due to late diagnosis, cultural taboos, and limited access to specialist care, AUB is yet another obstacle many face in silence.
Don’t Ignore The Warning Signs
Gynaecologists advise Nigerian women to seek medical attention if they notice any of the following: Heavy or prolonged bleeding; Unusual pain during their cycle; Nausea or vomiting alongside bleeding and Sudden changes in menstrual rhythm.
While healthcare access remains a challenge in many rural areas, early intervention—particularly in urban centres with established gynaecological services—is still the best path to restoring reproductive health.
Your Cycle Speaks—Listen To It
Abnormal uterine bleeding is more than a monthly inconvenience. For many Nigerian women, it’s a red flag waving beneath the surface of everyday life, signalling the need for care, conversation, and in some cases, critical intervention. The sooner it’s addressed, the better the prospects for fertility, wellbeing, and peace of mind.
Dr Taiwo Orebamjo is an experienced Consultant Obstetrician and a medical administration expert from the Kingston Academy of Learning and Career College Canada. He is a post-graduate of the Royal College of Obstetricians and Gynaecologists, London. The Research Fellow in assisted conception at the St. George’s Teaching Hospital in Tooting London is also the Consultant Obstetrician &Gynaecologist, Medical Director, at Parklande Specialist Hospital & Lifeshore Fertility and IVF Clinic.