Heavy Bleeding Specialist

What is Abnormal Uterine Bleeding?

In your 30s and 40s, as you approach menopause, you’re more likely to experience abnormal uterine bleeding. This may include any of the following:   

• Irregular periods that vary in length significantly
• Very heavy periods that cause pads or tampons to be soaked quickly
• Menstrual cycles that are longer than 38 days, or shorter than 24 days
• Periods that last longer than a week
• Bleeding or spotting between cycles or after sex

What Causes Abnormal Uterine Bleeding?

It’s common to experience abnormal periods at certain times in your reproductive life. Periods can be somewhat irregular when they first begin, for example, and they may also become irregular as menstruation winds down in preparation for menopause.

When abnormal uterine bleeding happens at any other time in your life, it may be caused by some other factor or condition, including:

• Hormone-Related Conditions: Thyroid conditions, polycystic ovary syndrome (PCOS), and stopping or changing birth control medications all can cause abnormal bleeding
• Noncancerous Growths: Endometrial, uterine, and cervical polyps can cause spotting, heavy periods, or other types of abnormal uterine bleeding, as can uterine fibroids.
  
• Sexually Transmitted Infections (STI's): Gonorrhea, chlamydia, vaginitis, and pelvic inflammatory disease (PID), among other STIs, may give rise to abnormal uterine bleeding.
• Cancer and Precancerous Conditions: Abnormal uterine bleeding may be a sign of cancer of the cervix, uterus, ovaries, or vagina; it may also be a symptom of precancerous conditions, such as endometrial hyperplasia.
• Reproductive Factors: Abnormal bleeding may be a sign of an ectopic pregnancy, or it may occur during early pregnancy because of fluctuating hormone levels. Any uterine bleeding during pregnancy is reason to see your obstetrician.

How are Heavy Periods Evaluated?

In order to diagnose the cause of your abnormal periods, your provider at Women’s Healthcare of Princeton will ask you detailed questions about your medical history and perform a comprehensive physical exam. You may need an ultrasound, which can be performed in our office, or other types of imaging. Lab tests are sometimes necessary to check hormone levels. In some patients, an in-office biopsy of the uterine lining is recommended to check for abnormal cells.

How are Heavy Periods Treated?

After the cause of your abnormal periods is properly diagnosed through a comprehensive physical exam and any necessary imaging or lab tests, your provider at Women’s Healthcare of Princeton can recommend the best course of treatment.

Depending on the root cause of the problem, hormonal medications may help your menstrual cycle become lighter and more regular. These medications can be in the form of a pill, vaginal ring, injection, or intrauterine device. If you don’t want to use birth control, there are other medications that can help control heavy bleeding.

If you have a problem that won’t respond to medication, you may require surgery. Heavy bleeding can often be successfully treated with NovaSure® endometrial ablation. This five-minute in-office procedure uses radiofrequency energy to target the endometrial lining from your uterus, effectively eliminating the very source of heavy bleeding. The NovaSure procedure is intended for premenopausal women who are finished having children.

If your heavy bleeding is related to polyps or fibroids, you may benefit from minimally invasive procedures to treat the structural problem. These procedures may be performed in the office or at the outpatient surgical center.