Ask a Women’s Health Texas Doctor: Understanding Uterine Bleeding

John Adams, MD, FACOG with Women’s Health Texas in San Antonio recently answered questions about what causes abnormal uterine bleeding and how it’s diagnosed and treated.

What is Abnormal Uterine Bleeding?

Bleeding in any of the following situations is considered abnormal uterine bleeding: bleeding or spotting between periods; bleeding or spotting after sex; heavy bleeding during your period; menstrual cycles that are longer than 38 days or shorter than 24 days; irregular periods where cycle length varies by more than 7-9 days and bleeding after menopause.

What causes abnormal bleeding?

Some of the causes include:

problems with ovulation;
fibroids and polyps;
endometrium growing into the wall of the uterus;
bleeding disorders;
problems from some IUDs or birth control pills;
miscarriage;
an ectopic pregnancy; or certain types of gynecological cancers.

How is abnormal bleeding diagnosed?

A visit with your Women’s Health Texas gynecologist is the first step to discuss your health history and your menstrual cycle. It may be helpful to keep track of and record your menstrual cycle before your visit. You will have a physical exam and may have blood tests to check your blood count and hormone levels and rule out some diseases of the blood. You also may have a pregnancy test and tests for sexually transmitted infections (STIs). Based on your symptoms and your age, other tests may be needed. Some of these tests can be done in your doctor’s office. Others may be done at a hospital or surgical center.

How abnormal bleeding treated?

Medications often are tried first to treat irregular or heavy menstrual bleeding such as hormonal birth control methods or other hormonal medication to help regulate and reduce bleeding. If medication does not reduce your bleeding, a surgical procedure may be needed.

There are different types of surgery, depending on your condition, your age, and whether you want to have more children. This includes myomectomy, ablation, uterine artery embolization, and hysterectomy if other treatments have failed.

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