Many women experience some type of abnormal vaginal bleeding (heavy periods, spotting, continuous bleeding or post-menopausal bleeding) at some point in their lives. The bleeding may be as simple as an irregular period or a sign that something else wrong. If you are experiencing abnormal bleeding, it’s important to be evaluated by your physician or healthcare provider to determine the cause and find a treatment. While there are many causes for abnormal periods, some common causes are fibroids, polyps, pregnancy, endometriosis and irregular hormones.
Fibroids are non-cancerous tissue growths in the muscle walls of the uterus. Another medical term for fibroids is “leiomyoma” or just “myoma.” Fibroids can grow as a single mass, or there can be multiple fibroids in the uterus. They can be as small as an apple seed or as big as a grapefruit. There are several different fibroid types with different names depending on where they grow on the uterus. Fibroids can grow on a stalk (inside or outside) the uterus (pedunculated fibroid) or may grow inside the wall of the uterus (intramural fibroid).
Submucosal fibroids grow inside the cavity of the uterus and irritate the lining of the uterus. Fibroids that grow under the covering of the uterus are called subserousal fibroids. Symptoms from fibroids vary and may by none at all or extremely heavy periods and pelvic pain. Treatment for fibroids depends on the type of fibroid, childbearing desires, and symptoms. Your SOGA physician or nurse practitioner can help you determine if you have fibroids and what the treatment options include.
Uterine polyps are small, non-cancerous protrusions of tissue that grow on the uterine lining (endometrium). They are overgrowths of the same kind of cells as the lining itself and may appear as finger-like projections or little mushrooms. As they grow, they become fragile and bleed, and as such, they are a common cause of abnormal uterine bleeding and sometimes bleeding after menopause (post menopausal bleeding).
It is estimated that 10% of women have uterine polyps and that polyps are present in up to 25% of women who are experiencing abnormal bleeding. Small polyps can often be diagnosed and removed in the office by your SOGA provider in a procedure called office hysteroscopy.
Occasionally one of the first signs of pregnancy can be abnormal vaginal bleeding. After making the diagnosis of a pregnancy, your SOGA provider will determine what lab tests and ultrasound tests need to be done to evaluate the bleeding. Sometimes abnormal bleeding may be a sign of a miscarriage or ectopic (tubal) pregnancy but bleeding can also be seen in normal early pregnancy.
Endometriosis is a female health disorder that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. This can lead to pain, irregular bleeding, and problems getting pregnant (infertility).
Women may experience menstrual (period) abnormalities in all phases of their child bearing years. When girls start puberty, they may notice irregular cycles as their bodies and hormones mature. Women in their 40s (or even as early as their 30s) start to experience hormone changes that cause shorter or longer cycles, heavier flow or more frequent periods.
The changes are caused by irregular fluctuations of progesterone and estrogen that happen when the body does not ovulate regularly. Lab testing, tissue sampling and ultrasound can all be used to evaluate hormonal bleeding. Depending on the findings, your SOGA provider can find safe and effective treatment options for hormonal bleeding in all ages.