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CAUSES OF ABNORMAL BLEEDING:
It is usually quite simple to find the cause of abnormal menstrual bleeding, although occasionally the cause may not be found. Since abnormal uterine bleeding can be caused by disorders of the uterus, hormone imbalance, pregnancy and general medical illnesses - it is helpful to look at each area separately. When I see someone for abnormal bleeding, I ask the following questions:
Is she pregnant?
Is she taking hormonal medication?
Is there a structural problem with the uterus?
Is there a General Medical Illness
Take careful MEDICAL HISTORY
Do a careful PELVIC EXAM
Perform HIGH RESOLUTION VAGINAL ULTRASOUND - quick, not really uncomfortable, provides invaluable information.
Rule out Pregnancy (Pregnancy Test)
Rule out Thyrdoid Disease (TSH Hormone Test)
Rule out Bleeding Disorder (Coagulation Tests)
Frequently the diagnosis can be made on the basis of the history, exam and simple lab tests & ultrasound.
Depending on the findings,
Other tests may be necessary
3D Sonohysterogram - to look inside the uterus using 3D Ultrasound & sterile water to accomplish "virtual hysteroscopy".
Hysteroscopy - to look inside the uterus either with a slender telescope called a hysteroscope that is inserted through the cervix
Endometrial Sampling - to sample tissue from inside the uterus using a tiny plastic "pipelle"
If you are particularly anxious, I can do procedures with mild sedation. Someone else must drive you. This is generally unnecessary. After we have eliminated dangerous or obvious causes, we can usually treat you with medicines or watchful waiting. We are happy to answer questions and concerns. Because no two people are exactly alike and recommendations can vary from one person to another, it is important to ask questions to make sure you understand your cause of bleeding. Once the cause of bleeding has been thoroughly evaluated, we will discuss all of the treatment options available.
Birth control pills - reduce bleeding an average of 40 %c
Motrin or Aleve (NSAIDs) reduce bleeding by 20%
Progesterone - generally short term use only.
Mirena Intrauterine device - reduces bleeding by an average of 75%
SURGERY (depending on a known cause)
Hysteroscopic Surgery / Endometrial Ablation
Myomectomy - for Fibroid tumors.
Uterine Artery Embolization - for Fibroid tumors.
KEEP A RECORD OF YOUR BLEEDING:
Go to iTunes or Google store and look for an App. my favorites are:
Period Tracker Pro (Pink Pad)
Period Tracker Deluxe
Cleveland Clinic – Abnormal Menstruation
Am. College ObGyn – Abnormal Menstruation