Abnormal uterine bleeding is any bleeding that occurs outside of your normal menstrual cycle. A normal cycle lasts from four to seven days in most cases and typically recurs every four weeks. Spotting between periods, periods that last longer than seven days or are shorter than four days, and periods with very heavy bleeding are all considered abnormal uterine bleeding.
Heavy menstrual bleeding is considered bleeding in excess of 3 ounces of menstrual fluid. But for practical purposes, it includes periods that:
Women with a heavy menstrual flow may pass large clots, and some women become anemic.
Most abnormal uterine bleeding is caused by hormonal imbalances, including imbalances due to perimenopause, polycystic ovary syndrome, and other medical issues. Some birth control methods can also affect a woman’s periods. Other causes include:
Significant changes in weight or periods of extreme stress of strenuous physical activity can also cause changes in a woman’s menstrual flow.
The doctors at Gresham Women's Healthcare begin diagnosis with a review of the patient’s symptoms and medical history, followed by a pelvic exam, a Pap smear or HPV test, blood tests, and other tests. Many patients have ultrasound imaging to obtain detailed pictures of the uterus and other internal structures. Some patients also may have minimally-invasive diagnostic procedures like hysteroscopy or colposcopy to evaluate the interior of the vaginal canal, the cervix, the uterus and the fallopian tubes.
Once the cause has been determined, treatment will be based on the specific cause of abnormal bleeding and will include medications to treat PCOS, thyroid disease, or hormonal imbalances. Treatment for menorrhagia (heavy menstrual bleeding) and other abnormal uterine bleeding may also call for procedures to remove fibroids, cysts, or polyps.
In some cases, a hysterectomy is necessary to resolve severe cases of bleeding. The doctors at Gresham Women’s Healthcare are prepared to discuss and perform this surgery on appropriate patients.
The doctor may also recommend lifestyle changes like reducing stress or losing weight. Each treatment will be customized for the patient’s unique needs.
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