Excessive vaginal bleeding during menstruation or vaginal bleeding between periods signifies a possible problem in a woman’s reproductive system. Abnormal bleeding should be diagnosed and solved as soon as possible, not only because it could be a symptom of a serious condition, but because the bleeding itself could cause further problems.
Safety First
At Academia, our first task is to check for, and control, anemia.
Frequent or abnormally heavy blood loss can result in a significant loss in red blood cells. Red blood cells carry oxygen and iron through the body, and dispose of carbon dioxide. Therefore, women who have become anemic can suffer from constant fatigue, dizziness, lightheadedness, and/or fainting spells, as well as an increased risk of heart problems.
Finding the Cause
Many gynecologic and non-gynecologic conditions can result in abnormal vaginal bleeding. We talk with the patient to explore her personal and medical history for clues. Have there been any recent changes in medications? Does bleeding occur during or after sexual intercourse? Is the patient ovulating regularly? Is she a teenager who has always had heavy periods? Is she menstruating at regular intervals? Has her menstrual flow decreased? Is she pregnant? Does she have a sexually transmitted disease?
Possible causes of abnormal vaginal bleeding include:
- Complications of early pregnancy
- Problems related to the use of hormones (contraceptives or hormone replacement therapy)
- Polyps (small benign growths)
- Endometrial Hyperplasia (overgrowth of the lining of the uterus, called endometrium)
- Fibroids (non-cancerous growth of uterine smooth muscle tissue)
- Adenomyosis (growth of uterine lining outside of the uterus)
- Endometrial cancer (unusual, and more frequent in women over 40)
- Cervical and vaginal cancers or other pathology
- Hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)
- Inherited clotting or platelet disorders, or misbalance in medications affecting those
- Infections involving the uterus
- Hormonal transitions seen in adolescence and perimenopause
- Psychological stress
To find the source of the problem, I addition to attentive review of histories, our evaluation may include:
- A thorough physical examination
- A pregnancy test when indicated
- Evaluation of the kidney, thyroid, and liver functions, testing for sexually transmitted disease, and hormonal function
- Cervical evaluation with pap smear, colposcopy , or biopsy as needed
- A high resolution ultrasound examination to check for uterine fibroids, adenomyosis, or endometrial problems
- Endometrial sampling – taking a sample and testing a small piece of tissue from the inner lining of the uterus
- Hysteroscopy – a minimally invasive surgical technique used to see inside the uterus and treat the problems originating in the uterine cavity
Treatment
Depending on the cause of abnormal vaginal bleeding and patients reproductive and life goals, treatment may vary. At Academia, treatment options include:
- Adjustment of current hormonal medications or initiation of new ones
- Prescription of antibiotics to eliminate suspected infection
- Hysteroscopic surgery in office and outpatient
- Endometrial ablation – a minimally invasive procedure that removes the uterine lining
- Laparoscopy or robotic surgery– a minimally invasive surgical technique used to remove uterine fibroids, or other benign growths
- Laparoscopy or robotic surgery for hysterectomy (4 types of laparoscopic/outpatient hysterectomy can be performed by our team)
- Other holistic, hormonal, and minimally invasive surgical techniques
One Final Note
Depending on the diagnosis, the cause of abnormal vaginal bleeding can lead to serious disease, including uterine cancer, if left untreated. If you suffer from heavy vaginal bleeding or spotting, please see your doctor – the sooner the better.
Of course, you are warmly invited to make an appointment with Dr. Assia Stepanian at Academia of Women’s Health & Endoscopic Surgery. We are uniquely equipped to diagnose and treat all forms of gynecologic problems. Our offices are remarkably beautiful and comfortable, and our approach is compassionate, holistic, complete, and minimally invasive.