Abnormal Bleeding Specialist

What are the causes of abnormal uterine bleeding?

Abnormal uterine bleeding includes bleeding that deviates from a normal menstrual period, including:

• periods that last longer than normal (more than seven days)
• periods that are heavier or lighter than normal
• spotting between periods
• periods that occur on an irregular schedule (most periods occur about every 28 days)
• the complete absence of periods or periods that occur rarely

What causes abnormal bleeding?

All of these issues can have different causes, including:

• menorrhagia, abnormally heavy periods that occur in women approaching menopause
• polycystic ovary syndrome (PCOS)
• hormonal fluctuations due to age or other causes
• birth control pills
• uterine fibroids
• endometriosis
• thyroid disease
• pregnancy or miscarriage
• chronic stress
• strenuous physical activity
• significant changes in weight
• breastfeeding
• tumors or cysts

How is the cause of abnormal bleeding diagnosed?

Diagnosis begins with a review of the patient’s symptoms and medical history, followed by a physical exam. Depending on the symptoms, blood tests, urinalysis, ultrasound or other evaluations or tests may be ordered, and a pelvic exam and Pap test will be performed. Additional exams may also be performed to evaluate the vaginal canal, uterus or fallopian tubes.

How can I tell if I have menorrhagia?

Menorrhagia is relatively common among women approaching menopause. Hormonal fluctuations during that time can cause the uterine lining to thicken, and menstrual flow can be much heavier than normal. In women with menorrhagia, tampons alone typically are not enough to control blood flow, and most women will need to change sanitary napkins very frequently throughout the day and even during the night. Fortunately, there are outpatient procedures that can be used to treat menorrhagia to help women return to their normal lives.

What treatments are available for abnormal bleeding?

The treatment for abnormal bleeding will depend on the underlying cause. For menorrhagia, treatments are available to remove the uterine lining so symptoms are relieved. Hormone replacement therapy (HRT) can help manage many causes of abnormal bleeding, and minimally-invasive procedures are available to treat endometriosis and fibroids. In cases of severe bleeding that don’t respond to more conservative approaches, hysterectomy may be an option. Other causes, like thyroid disease, can be treated with medications. Each treatment plan will be customized based on the patient’s needs and the underlying cause.