A normal menstrual cycle occurs every 28 days, and the period of bleeding lasts anywhere from 3 – 7 days. Abnormal bleeding is bleeding that occurs outside of this pattern and sometimes indicates that there is a problem with your cervix or uterus
Abnormal bleeding can be described as:
- Spotting or bleeding between periods
- Heavier bleeding
- Bleeding for a longer period of time than normal
- Bleeding after sex
- Bleeding after menopause
- Lack of menstrual bleeding for 3-6 months, also known as amenorrhea
While abnormal bleeding may indicate that something is wrong, some irregular bleeding can be normal at certain stages of life. For instance, girls ages 9-15 might experience some abnormal bleeding while their menstrual cycles are just getting started. Additionally, as women approach the age of menopause their cycles may get longer or they may skip a period once in a while. These are both examples of times when women’s monthly cycles are adjusting to their fluctuating levels of hormones.
What Causes Abnormal Bleeding?
Sometimes abnormal bleeding can signal a more serious problem. Some common causes include:
- Infections (cervical or uterine)
- Issues with a birth control device (IUD or pills)
- Blood clotting problems
- Ectopic pregnancy
- Adenomyosis (a disorder of the endometrial tissue)
- Endometrial hyperplasia
- Polycystic ovarian syndrome
- Cervical, uterine, or vaginal cancer
If you’re concerned about abnormal bleeding, please make an appointment with us so we can perform a full evaluation and workup. If you can, keep a log of the dates that you begin and stop bleeding, and record whether the bleeding was light, medium, or heavy, and as well as any other symptoms you may have.
Testing and Diagnosis for Abnormal Bleeding
Abnormal bleeding can have a wide range of possible causes. At your appointment, we’ll perform a pelvic exam and ultrasound. We may ask that you take a blood test and/or a pregnancy test.
Some other tests can help with diagnosis as well. Depending on the results of your exam and blood test, we may want to get a better idea of what’s going on in your uterus by using:
- Sonohysterography – A procedure in which an ultrasound is performed after the uterus is filled with fluid.
- Hysteroscopy – a long, thin device with a light and camera at the end is inserted through the cervix to view the inside of the uterine cavity.
- Endometrial biopsy – A sample of endometrial tissue is taken from the uterine lining and examined under a microscope.
Treatment for Abnormal Bleeding
Women who have abnormal or heavy periods are sometimes prescribed birth control pills or other hormonal treatments (injections, rings, creams, or an IUD) in an effort to regulate their cycles. Your doctor can discuss your options with you. Some women have to try a few different types of hormonal treatment before they find the one that works for them.
Other drugs used to treat abnormal bleeding include antibiotics (for infections) and NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen, which can control heavy bleeding and ease cramping.
Some disorders that cause abnormal bleeding might require surgery. Uterine polyps or fibroids are often removed surgically. Under certain circumstances, an endometrial ablation or complete hysterectomy may be recommended. These surgeries will permanently reduce bleeding or stop the bleeding entirely, and should only be performed when a woman is sure that she no longer wants to get pregnant.