Abnormal Uterine Bleeding

Abnormal uterine bleeding is common reason for women to be evaluated by a gynecologist. The normal menstrual flow lasts on average 5 days. The interval from the first day of one menstrual flow to the first day of the next menstrual flow is 21-35 days. 80 ml is the normal amount of blood a woman should pass during her period, however, and increase from what she normally experiences can also be considered abnormal and require evaluation. The definition of abnormalities experienced during the menstrual cycle involve too much blood, menorrhagia, episodes of bleeding less than every 21 days, polymenorrhea, or intervals greater than every 35 days, oligomenorrhea. Lastly, bleeding in between one’s normal flow which is considered metrorrhagia.

There are several causes of abnormal uterine bleeding which can be secondary to uterine masses, hormonal abnormalities, bleeding disorders, medications, infections or malignancy. There are some instances in which the cause of the abnormal bleeding and cannot be defined.

The evaluation for abnormal bleeding includes a thorough history of your bleeding and the changes that have occurred, a physical exam, lab work and sometimes imaging in the form of an ultrasound. The lab work suggested normally include a complete blood count, thyroid levels, pregnancy test, screening for bleeding disorders and infections. Imaging can include a pelvic ultrasound, hysteroscopy and magnetic resonance imaging. When indicated sampling of the endometrial lining by a gynecologist may be needed in the form of a endometrial biopsy or an hysteroscopy with endometrial sampling.

Treatment for abnormal uterine bleeding is typically managed by a gynecologist, focusing on addressing the underlying cause. This may involve medical management of hormonal imbalances through birth control or hormone replacement therapy, which can help reduce bleeding. Medications may also be prescribed to alleviate symptoms associated with bleeding disorders. In some cases, surgical interventions may be necessary to remove uterine masses contributing to abnormal bleeding.

Emergent evaluation by a healthcare provider may be required in specific situations, such as when a woman is soaking through a pad or tampon every hour for several hours. It is also urgent if she experiences lightheadedness or dizziness alongside heavier-than-normal bleeding. Additionally, postmenopausal women who suddenly experience bleeding should seek care with our office as soon as possible.

If you notice a change in your bleeding pattern, Lifelong Wellness & Gynecology encourages you to contact our office at (571) 425-4100 or book online to schedule an appointment for a comprehensive evaluation.