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ABNORMAL UTERINE BLEEDING

WHAT IS CONSIDERED TO BE ABNORMAL BLEEDING?

  • Bleeding that occurs between menstrual periods
  • Bleeding after sex
  • Bleeding after menopause
  • A change in bleeding patterns (i.e. heavier bleeding or bleeding that lasts for more days than usual)

IRREGULAR BLEEDING PATTERNS THAT ARE NORMAL

  • Bleeding patterns can occur irregularly in the first few years of a girl’s period. This is normal and will usually become more regular with time.
  • Irregular bleeding can also occur when a woman is reaching menopause. Bleeding may get lighter, heavier or less frequent/less regular during this time. This change in pattern may be normal, but consult with your physician.

WHEN SHOULD I SEE A HEALTHCARE PROVIDER?

  • If you are a premenopausal woman (you have not had menopause yet) and you experience vaginal bleeding between menstrual periods, after sex, or have changes in bleeding patterns (heavier bleeding or bleeding that lasts longer than usual)
  • If you experience bleeding after menopause

WHAT ARE THE MOST COMMON CAUSES OF ABNORMAL UTERINE BLEEDING?

  • Pregnancy
  • Fibroids
  • Adenomyosis
  • Uterine polyps
  • Some types of birth control (IUD, pills, patch, ring, implant)
  • Infection of uterus or cervix
  • Endometrial hyperplasia
  • Polycystic ovarian syndrome
  • Clotting/Bleeding disorders
  • Trauma or foreign body
  • Cancer of the cervix, uterus or vagina

WHAT TESTS CAN I EXPECT IF I HAVE ABNORMAL BLEEDING?

You will be asked for a menstrual and bleeding history, likely have a pelvic exam, and there may be other tests such as blood work, a pregnancy test, a pap smear, ultrasound, or endometrial biopsy (biopsy of the uterine lining), depending on the findings.

MANAGEMENT AND TREATMENT OF ABNORMAL UTERINE BLEEDING

Some women can be treated with hormonal medications and others with surgery, depending on your diagnosis. The type of treatment depends on the cause of bleeding, a woman’s age, and desire to have future children.

  • Hormonal medications are most commonly used to manage abnormal uterine bleeding. These include birth control pills, injection, IUD. Your doctor will provide details about these options and which might be best for you.
  • Other medications that may be used are nonsteriodal anti-inflammatories, tranexamic acid (may prevent breakdown of blood clot) or antibiotics if an infection is present.
  • Surgeries such as hysteroscopy, endometrial ablation, myomectomy (removal of fibroids, sparing the uterus), or hysterectomy may be suggested in the management of polyps or fibroids that cause bleeding.

|    © 2014-2018 copyright Taraneh Shirazian, MD

wwc   ny

Joan H. Tisch Center for Women's Health

207 E 84th Street

New York, NY 10028

Phone: 646-754-3300

 

Email: info@wwcofny.com