Abnormal Vaginal Bleeding is not something that women should have to live with and can be related to a number of reproductive or medical conditions. Normal
menstrual bleeding usually occurs every 21-35 days and lasts for around seven days (this can vary). While it is normal for there to be some variation between each cycle, you should not experience frequent vaginal bleeding between periods.
There are many different causes of intermenstrual bleeding or vaginal bleeding that occurs during the menstrual cycle other than during regular menstruation, including:
- Polyps: An overgrowth of cells around a small blood vessel is called a polyp, which can occur on the cervix or inside of the uterus.
- Contraceptives: Certain methods of contraception can cause abnormal bleeding, specifically in the first few months after starting the new method.
- Pelvic Infections: Bleeding between periods may be a sign of an infection on the cervix or in the uterus. Patients who have a pelvic infection can experience pelvic pain or increased vaginal discharge along with bleeding.
- C-section Scar Defects: Some women who have undergone a cesarean section may experience bleeding that begins just after the end of their regular menstruation.
- Cancer or Precancer: Cancer or a precancerous growth located on the uterus or cervix can be the cause of intermenstrual bleeding. Some women may also experience what is known as irregular bleeding, which is when a woman experiences phases of no bleeding that may last for two or more months and other phases with spotty or heavy bleeding. Irregular bleeding is usually related to abnormal ovulation or polycystic ovarian syndrome (PCOS).
HOW IS ABNORMAL BLEEDING DIAGNOSED?
If you are experiencing abnormal uterine bleeding, I will begin by taking the time to understand your symptoms and your overall health. I will ask about your medical history, menstrual cycle, and any changes you have noticed, including the timing, duration, and amount of bleeding. I may also ask you to keep a record of your menstrual cycles, as this information can help me identify patterns and determine the underlying cause of your bleeding.
As part of your evaluation, I will perform a thorough physical and pelvic examination and may recommend blood tests to check your blood count, hormone levels, and other possible causes of abnormal bleeding. Depending on your age and symptoms, I may also request a pregnancy test or screen for sexually transmitted infections (STIs) when appropriate. If additional evaluation is needed, I may recommend imaging studies such as a pelvic ultrasound, MRI, or CT scan, or perform an endometrial biopsy to examine the lining of your uterus. These tests help me accurately identify the cause of your abnormal bleeding so that I can create a personalized treatment plan tailored to your specific needs.
TREATMENT OPTIONS FOR ABNORMAL BLEEDING
The treatment that is right for you will depend on the cause of your abnormal bleeding, which Dr. Krizzie will discuss with you during your appointment. Some treatment options that may help to resolve your abnormal bleeding include:
- Hormonal Birth Control: Birth control pills, patches, or vaginal rings that contain hormones can help to lighten menstrual flows and regulate periods.
- Intrauterine Device (IUD): An IUD is a small, plastic device that is inserted into the uterus to prevent pregnancy. The type of IUD that releases hormones can be used to reduce abnormal bleeding in some women.
- A D&C (Dilation and Curettage): A D&C is a procedure done to scrape away the lining of the uterus. The removed lining is then examined in a lab for abnormal tissue. Women experiencing heavy bleeding may undergo this procedure to determine the cause for, and treat, the bleeding.
- Endometrial Ablation: This procedure destroys the lining of the uterus. This treatment may stop all menstrual bleeding in some women.
- Hysterectomy: This is a surgical procedure to remove the uterus. Women who have a hysterectomy will not have any more periods and will not be able to get pregnant.