Abnormal uterine bleeding is more than just a minor nuisance. Heavy or unpredictable bleeding can cause minor embarrassment or major complications, even in young women who are otherwise healthy. Some women become anemia from chronic blood loss, to the point of needing a transfusion. Often abnormal bleeding is associated with severe cramping or pain that can become disabling, interfering with normal daily activities.
Women of all ages can be plagued by abnormal uterine bleeding. Young teens sometimes experience severe prolonged and heavy menstrual periods that threaten their education because of interference with school attendance. Reproductive aged women can have recurring abnormal bleeding associated with infection, hormone imbalances, and pregnancy complications. Middle aged women commonly experience abnormal bleeding as menopause approaches since hormone levels fluctuate. They may also have fibroid tumors or polyps. Older women can experience post menopausal bleeding that may reflect the development of cancerous or precancerous cells in the cervix or uterus. All women with abnormal uterine bleeding should be evaluated thoroughly with appropriate testing.
Indicated tests may include a pelvic examination, pregnancy testing, cervical cultures, blood testing for hormone levels, thyroid, clotting studies and testing for anemia. An ultrasound may be needed to evaluate for uterine masses, ovarian cysts, or a thickened lining of the uterus. Some women need a biopsy of the uterus, or a hysteroscopy procedure to visualize the lining of the uterus and take directed biopsies.
Treatment may include
1. Hormones, generally the same hormones as are found in birth control pills.
2. Antibiotics against infections that can cause abnormal bleeding and can also cause infertility.
3. Medications that affect blood clotting in the uterus reducing the monthly flow of blood.
4. Merina, an IUD that delivers progesterone, a uterus stabilizing hormone directly to the uterine lining.
5. Dilation and Curettage under local anesthesia and sedation
6. Endometrial ablation using a cryoprobe called Her Option, under local anesthetic and sedation.
7. Hysterectomy for severe cases that do not respond to other treatments.
Dr. Holley does all of these treatments except for the hysterectomy. If hysterectomy is your only good option, she will refer you to a physician who can give you a safe and positive experience given your history and preferences.