Abnormal Bleeding

Ilene Goldstein 001At Virginia Beach Obstetrics and Gynecology, we are pleased to offer comprehensive evaluation and treatment for abnormal uterine bleeding. Abnormal uterine bleeding encompasses bleeding between periods, bleeding after intercourse, spotting any time in the menstrual cycle, heavy or prolonged menstrual flow and bleeding after menopause. Menstrual cycles with an interval longer than 35 days or shorter than 21 days are typically considered abnormal. Additionally the lack of the menstrual period for 3 to 6 months is also abnormal.

Abnormal bleeding can have many causes including pregnancy, miscarriage, ectopic pregnancy, adenomyosis, the usage of certain contraceptive methods, cervical and uterine infection, uterine fibroids or polyps, clotting disorders, and endometrial hyperplasia as well as uterine and cervical cancer and polycystic ovary syndrome.

If you have abnormal bleeding you should speak with us about it. We will ask about your personal family health history as well as your menstrual cycle history. It is helpful to keep track of your menstrual cycles prior to your visit. We consider the first day of bleeding to be cycle day one. Note the date, duration and type of bleeding on the calendar.

Your evaluation may include a physical exam, pelvic exam, pap test, infection screening, laboratory tests such as hormone levels and blood count. It may include imaging of your pelvis by ultrasound or MRI. Some women requiring endometrial biopsy where a narrow flexible tube is inserted into the uterus to retrieve cells that line the uterus for microscopic evaluation. Some women require hysteroscopy where a narrow endoscope with a camera is inserted into the uterus to visualize the cavity.

There are numerous treatments available for abnormal uterine bleeding. Typically the treatment elected depends on many factors including the cause of bleeding after evaluation, the age and health history of the patient and plans for future childbearing. Many women can often be treated with medication. Others might need surgery.

Hormonal medications are often used to control every leader and bleeding. These can be administered as oral, transdermal or injectable agents. Sometimes the patient is treated with an intrauterine device that releases hormones to eliminate abnormal bleeding. Other medications given for abnormal bleeding include nonsteroidal anti-inflammatory drugs, tranexamic acid, and antibiotics.

Some women may need to have surgery to remove growths such as polyps or fibroids that cause bleeding. For women with abnormal bleeding who have completed childbearing an endometrial ablation can be used to control bleeding. This minor procedure which can be performed under sedation in the office is intended to reduce or eliminate bleeding permanently.

When other treatments have failed or are not an option, women can choose a hysterectomy (removal of the uterus) after which time, they will have no periods.