Irregular or Abnormal Bleeding
Irregular or abnormal bleeding patterns are no laughing matter - they can be indicative of a serious condition that needs to be treated without delay. And when unusual bleeding turns out to be a relatively minor issue - you still don’t feel like it’s “minor” until it is corrected and will be grateful for the peace of mind that comes with a professional OB-GYN examination to see what’s wrong.
At Gyn LA, we are here to help when your regular period experiences unexplained disruptions or if for any other reason you experience irregular/abnormal bleeding as a woman of any age. Do not hesitate to reach out to us by calling 310-375-8446 for a free consultation and to schedule an in-office exam!
What Do We Mean By “Irregular Or Abnormal Bleeding?”
The first thing to remember is that women vary greatly in what is “normal” as to bleeding during their period. A few minor changes or surprises may not be a big deal, but when the flow is so heavy or unpredictable that it is interfering with your work, school, or everyday routine, it is cause for a gynecologist exam.
A typical menstrual cycle will last from half a week to a full week and can be spaced anywhere from 21 to 35 days apart. It is normal to lose up to 2.8 ounces (80cc) of blood during a period. Any bleeding outside of these parameters is considered “abnormal.” The closer a woman gets to menopause, the more likely that there will be some irregularities in her cycles - but since such irregularities can point to genuine problems as well, it is good to get them checked out.
Bleeding or spotting between periods, excessively heavy flow, irregular cycles, only having 4 to 9 periods per year, seeing large blood clots in the discharge, continuing to bleed for more than 7 days, always bleeding post-sex, and bleeding post-menopause are all signs of abnormal bleeding that should not be ignored.
If you are bleeding while pregnant or past menopause, don’t hesitate to contact us. Spotting a little early into a pregnancy is normal, but not later on or excessively. Bleeding during pregnancy could be a sign of an ectopic pregnancy, where a fertilized egg has been implanted outside the uterus (often in a fallopian tube) or a sign that a miscarriage may have occurred or may be in process - so don’t delay to see a gynecologist in such cases. It is normal to experience some bleeding in the first few weeks following giving birth, but not beyond that time frame.
If you are on a hormone replacement regimen following menopause, it is possible this will cause you to have periods. Otherwise, there is definitely something wrong. And even with hormone treatment going on, you should get any bleeding checked out to verify its cause. Unusual bleeding can come from the vaginal area or from the uterus. In either case, it can be a symptom of a dangerous condition, so it pays to get it diagnosed by a specialist.
Causes Of Irregular / Abnormal Bleeding In Women
We have touched on a few possible causes of abnormal bleeding above, but here we will delve into more detail. The range of possible causes is very wide indeed, so one cannot jump to quick conclusions about what is wrong. And a professional exam is a must.
Hormonal changes are a major cause of irregular bleeding. An infection of some kind is another common cause. If you are pregnant, a possible connection with the pregnancy must be explored first, and the age of the woman and the location of the bleeding are also key clues in figuring out the exact cause.
Hormone imbalance, leading to abnormal bleeding, can occur for a variety of reasons. For those just entering puberty or just reaching menopause, too many hormones might be released when an egg is released from the ovaries. This causes too thick of a lining to build up in the uterus, which can lead to heavy flow during periods or spotting between periods. Birth control pills or other contraceptives can also cause a hormone imbalance, as can rapid weight loss or weight gain, use of an intrauterine device, or extreme emotional/physical stress. The hormone disorder called polycystic ovarian syndrome is also a possible cause.
Infection of the uterus or vagina, trauma in the vaginal area, fibroids or polyps (benign tumors and growths) in the uterus, certain medications and medical conditions, a condition called adenomyosis, premature ovarian failure, bleeding or blood-clot disorders, use of blood thinners, and kidney, liver, thyroid, pituitary, or adrenal problems could be the culprit.
Certain cancers that affect the cervix, vagina, uterine lining, or endometrium can also cause abnormal bleeding. These cancers are rare but deadly. We at Gyn LA are adept at screening you for them and, in the unhappy event of a positive reading, alerting you early while more can be done - and then ensuring you get the treatment you need.
Less common causes of irregular or abnormal bleeding include pelvic inflammatory disease, urethral prolapse, hyperthyroidism, diabetes, sexual abuse, or an object lodged in the vagina. Excessive exercise can also cause heavy bleeding, but in most cases, it has the opposite effect (amenorrhea, light bleeding or skipping of the period.)
Note that sexually transmitted diseases (STDs) often cause infections in the vagina, ovaries, fallopian tubes, and elsewhere in the pelvic area and lead to abnormal bleeding. Bleeding should not occur after sex on a regular basis - that is abnormal and should be checked out.
Finally, there are many instances where the exact cause of abnormal or irregular bleeding cannot be determined. This condition is then labeled “dysfunctional uterine bleeding” (DUB). It can still be treated provided there is at least a general indication of what is causing the bleeding.
The Exam For Irregular / Abnormal Bleeding
When you experience any kind of significant irregularity in your menstrual cycle, you should take it very seriously. An exam may not turn up anything (and you hope there is no problem to find), but checking it out will not hurt and could avert a serious danger.
The first part of the examination will consist of simply talking to you about your problem. We will find out exactly where the irregularity lies, what medications you are taking (if any), when your last period was, how heavy and how often the bleeding or spotting is occurring, if you are or might be pregnant, and all other relevant information that could help steer us in the right direction as to finding the cause.
If your period is lasting over a week or less than 2 days, is shorter spaced than 3 weeks or longer than 5 weeks, or is losing you over 5 tablespoons of blood (2 tablespoons is normal and average), it is a sign of a problem. Bring any notes you have (or make them from memory) about your period patterns to give the doctor as full of information as possible during the exam.
A number of possible tests may be administered, as needed, during the exam - these include a blood test, dilation & curettage sample of the uterine lining, cervical smear, pregnancy test, and ultrasound. A basic physical will also be a part of the exam in most cases.
Blood tests will look for hormone levels and any other blood disorders or chronic diseases. The ultrasound would be looking for any fibroids or polyps in your uterus. A hysteroscopy exam may also have to be done to see inside your uterus, and biopsies from the vaginal or uterine area may be taken. Less commonly, an MRI scan may be needed to check for adenomyosis.
Obviously, the cause of the abnormal bleeding will impact which treatment option is appropriate. A chronic illness or blood problem will need ongoing treatment for sure. Hormonal imbalances can be corrected and prescription drugs used to combat infections. Whether or not you are pregnant or plan to become pregnant down the road may also affect how your condition is treated, as may your age (close to menopause, for example.)
Birth control pills or hormonal treatments may be used to cause your cycles to return to normal. Some medications will inhibit hormone production, while others will increase it. In some cases, use of an inter-uterine device that releases progestin into your system may stop excessive bleeding (and may even stop your periods completely.)
Use of anti-inflammatory drugs (such as ibuprofen and naproxen) just before your menstruation cycle starts up may make bleeding lighter. Capsules of tranexamic acid can be used to prevent large blood clots in your discharge. Simply ceasing to use a contraceptive or switching to use a different one are also possible solutions in some cases.
In certain instances, surgery may be needed or recommended to stop irregular or abnormal bleeding patterns. Surgical removal of fibroids or polyps is common enough, and in case of cancers, the cancerous tumor must be surgically removed. Sometimes, the blood vessels supplying a fibroid or polyp with blood are cut rather than actually removing them.
If fibroids are very large or if there is cancer of the uterus, a hysterectomy may be needed to actually remove the uterus. In other cases, endometrial ablation uses temperatures, lasers, or electricity to destroy the uterine lining to stop bleeding - this will mean that you won’t likely ever get pregnant. It can be dangerous, however, if you do get pregnant after having the uterine lining destroyed, so you would have to take birth control pills until you reach menopause to be safe.
Homecare Advice Following The Exam And/or Treatment
At Gyn LA, we are concerned that you know how to improve your at-home care habits to reduce or eliminate irregular or abnormal bleeding. The first step is to understand how your cycle works and what is a genuine sign of a possible problem.
When eggs are released from the ovaries, hormones are released with them. This triggers the formation of a lining on the uterus (womb), making it thicker in case of a pregnancy. Once you don’t get pregnant, the excess uterine wall is shed, and about 50% of what has shed consists of blood. That is why the menstrual cycle takes place, to begin with.
Fluids released can be anywhere from bright red to dark brown. It there are large blood clots or excessive particles in the flow, that is cause for concern. Anytime the timing, heaviness, or painfulness of your period experiences sudden, unexplained changes, do not hesitate to see an OB-GYN! Be sure to keep a diary of your periods so you have the information ready at hand, if at all possible when you see us!
But the other side of the coin is taking care of yourself at home on a regular basis. Eating a healthy, consistent diet, getting plenty of sleep and at regular times, and starting up an exercise program can all help reduce heavy bleeding. Excessive exercise may even stop bleeding entirely in some women.
Additional ways to help fight irregularities in bleeding cycles and reducing accompanying pain include: soaking your body in a warm bath, wearing loose-fitting clothing, getting a back rub or massage, taking a vitamin-B1 and/or magnesium supplement, laying a hot pack on the pained area, curling up your knees to your chest and lying on your side for 15 minutes a day, using various stress-reducing and relaxation techniques, and taking pain killers like paracetamol or ibuprofen - but avoid aspirin.
If you have a serious medical condition, then doing these at-home remedies will not fix it. But even then, it can help alleviate the pain and discomfort and minimize the problem bleeding. In some cases, merely changing your lifestyle in this way can solve the entire problem.
Looking For A Trusted OB-GYN Near Me?
At Gyn LA, we have deep experience in diagnosing and treating irregular or abnormal bleeding in women of all age groups in the Los Angeles Area. Do not ignore your bleeding problem - there is a solution, and we can find it!