ABNORMAL UTERINE BLEEDING

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Did you know that most abnormal menstrual bleeding problems are caused by an imbalance in hormones?

This may be related to the menstrual cycles, but at times abnormal bleeding may occur before the onset of menses, during pregnancy and after menopause.

Overwhelmingly, bleeding problems are caused by an imbalance in the hormones that control the menstrual cycle and are referred to as “dysfunctional uterine bleeding.” When vaginal bleeding is not related to the menstrual cycle, it is of increased concern. This is especially true when it occurs in childhood before menstruation has begun, during pregnancy, and at midlife, after a woman has entered menopause.

When to see the health care provider:

  • Periods less than 21 days apart or more than 45 days apart
  • Severe abdominal or pelvic pain occurs during menstruation or sexual intercourse
  • Menstrual bleeding is excessive (more than one pad or tampon per hour for several hours)
  • Menstrual periods lasting longer than 7 days
  • Bleeding or spotting between periods

Frequent periods/ Heavy periods

Polymenorrhea (Frequent Periods) or frequent irregular periods are typically due to problems with the way you produce hormones, or because there is a lump or bump in the pelvis (e.g. fibroids, polyps, ovarian cysts). If your periods or pain has changed it is important that you visit doctor so that some simple tests can be carried out. These may include a thorough examination, high vaginal swab (to look for infection), a cervical smear test (PAP) and an ultrasound scan.

Menorrhagia (Heavy Bleeding) is the medical term used to describe heavy periods. Technically you have heavy periods if you bleed more than 80 ml each month. In reality if you notice that your periods become more heavy or painful, you will become anemic (low blood count) from heavy periods, and you should seek medical attention, whatever the cause of your bleeding. Advancing age and having children are common causes of periods becoming heavier. There are also a number of pathological causes for Menorrhagia, particularly when there is associated pain.

Abnormal Uterine Bleeding will require further evaluation by Hysteroscopy with Endometrial biopsy and D&C.

Endometrial Biopsy – This procedure is obtains a sample of the endometrial lining and is usually performed at your physician’s office. It involves the insertion of a plastic pipelle (a small flexible tube), thru the opening of the cervix, into the uterus. Using suction, the pipelle plucks off a sample of tissue from the uterine lining and it is removed and sent for microscopic examination.

D & C – A procedure performed to obtain samples of the endometrium, the lining of the uterus to evaluate abnormal uterine bleeding or abnormal cells.

 

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