Abnormal Uterine Bleeding Specialist

What is abnormal uterine bleeding?

To understand when uterine bleeding is abnormal, it’s important to know when uterine bleeding is considered normal. A normal menstrual cycle usually lasts 24-38 days, from start to finish.

Sometime during this cycle, your uterus sheds its lining and causes you to bleed, or menstruate. A normal “period” of bleeding may last for four or five days, or it may continue for as long as a week. Normal menstrual flow ranges from light to moderately heavy.

Abnormal uterine bleeding can occur in a variety of ways:

• Bleeding or spotting between cycles or after sex
• Irregular periods that vary in length significantly
• Very heavy periods that cause pads to be soaked quickly
• Menstrual cycles that last longer than 38 days
• Menstrual cycles that are shorter than 24 days
• Any bleeding that occurs after menopause  

What causes abnormal uterine bleeding?

Abnormal uterine bleeding can happen any time after your menstrual cycle begins in adolescence. A wide range of underlying problems or gynecological conditions can be to blame, including:

Hormonal Problems

Thyroid conditions, polycystic ovary syndrome (PCOS), and changing hormonal birth control medications, or stopping hormone replacement therapy can all lead to abnormal uterine bleeding.

Noncancerous Growths

Endometrial, uterine, and cervical polyps can cause spotting, heavy periods, or other types of persistent bleeding problems. Uterine fibroids are another major cause of abnormal uterine bleeding.

Cancer and Precancerous Conditions

Abnormal uterine bleeding can be an indication of cervical, uterine, ovarian, or vaginal cancer; it may also be a symptom of precancerous conditions, such as endometrial hyperplasia.  

Sexual Infections

Gonorrhea, chlamydia, vaginitis, and pelvic inflammatory disease (PID), among others, can lead to abnormal uterine bleeding.

Reproductive Factors

An ectopic pregnancy can sometimes cause abnormal bleeding. It can also occur during early pregnancy, when hormone levels are still fluctuating. Any uterine bleeding during pregnancy is reason to see your obstetrician.

How is abnormal uterine bleeding diagnosed?

The first step in treating abnormal uterine bleeding is determining its underlying cause. Based on the results of a comprehensive physical exam, Dr. Caceres will order necessary lab tests and use diagnostic ultrasound imaging to help determine the nature of the problem.

If an ultrasound doesn’t reveal enough information, she may perform an in-office hysteroscopy procedure to examine the interior wall of your uterus.

If Dr. Caceres suspects you have a problem with your cervix, she may perform an in-office colposcopy to check the cells of your cervix and look for troublesome changes. Dr. Caceres uses a Dysis® colposcope, which uses advanced, high-resolution digital technology for a more precise diagnosis.

How is abnormal uterine bleeding treated?  

Some problems that cause abnormal uterine bleeding, including PCOS, can be controlled with hormonal birth control medications, which help regulate the menstrual cycle. Other medications can help control heavy bleeding or a known bleeding disorder.

If your problem won’t respond to medication, you may require surgery. Surgically removing uterine fibroids, for example, can put an end to abnormal bleeding. Other surgical procedures designed to treat abnormal bleeding include endometrial ablation and, when other treatments have failed, a hysterectomy.

Is abnormal bleeding ever expected?

There are times in a woman’s reproductive life when abnormal uterine bleeding may be somewhat “normal” or expected, although this type of abnormal bleeding usually resolves itself quickly.

Short-term abnormal uterine bleeding is more common when a menstrual cycle first begins in adolescence, and as women approach menopause and their hormone levels begin to fluctuate.

If you have a question about abnormal uterine bleeding, call your nearest office or schedule an appointment online today.