In-Office Evaluation — Abnormal Bleeding

Abnormal uterine bleeding occurs at various stages of a woman's life for different reasons. Causes of bleeding may be grouped into anatomical (polyps, fibroids), hormonal, and physiological. While not all abnormal bleeding is dangerous, it can be inconvenient and uncomfortable and affect a woman's normal daily living. The physicians at Women's Health Consultants can help you find a solution to this complex problem — a solution that fits your lifestyle.

Evaluation

The first step in evaluating abnormal bleeding is a thorough history and review of patient risks. A complete history and physical examination will help guide the workup. Hormonal and endocrine blood tests are often needed. A pelvic ultrasound is routinely performed to make sure anatomical disorders are not the cause. Generally, in women older than age 35, the workup may include an endometrial biopsy in the office. Specialized studies such as saline infusion sonogram and diagnostic hysteroscopy may also be recommended: these studies help visualize the uterine lining and are conveniently performed in our office.

Treatment

Treatment of abnormal uterine bleeding is based on the underlying cause. Depending on your age, the severity of bleeding, and desire for fertility, there are several treatment options available. Hormones such as combined oral contraceptives and progestins, and the Mirena IUD are often used to treat bleeding that is due to hormonal changes and irregularities. Women who have completed childbearing and have heavy menstrual bleeding can consider a procedure such as endometrial ablation. Surgery may be necessary to remove abnormal uterine structures (e.g., fibroids, polyps). Finally, hysterectomy may be the treatment option for many patients.

We understand the various underlying causes of abnormal uterine bleeding. We also understand the need for individualized treatment plans. You can trust that we will spend the time to discuss the issues and find the most suitable solution to your bleeding problem.