"I'm amazed at how many women come into my office, having suffered with heavy bleeding for
years. Many have gone to multiple physicians, and have tried
numerous treatments without ever finding out the cause of the bleeding."
Why am I bleeding so much?
Possible causes are...
Hormone imbalance can cause
irregular bleeding. It is usually possible to evaluate this by history and by
using methods to evaluate ovulation. If a woman is on birth control pills,
then her hormones are controlled by the pills. Estrogen replacement after
menopause can also cause bleeding.
Problems with the uterus, such as
fibroid tumors are common causes of abnormal bleeding. Polyps are growths on
the lining of the uterus that can bleed. Adenomyosis is a condition in
which the endometrium (the lining of the uterus) grows into the wall of the uterus.
Click here to learn more about causes of abnormal bleeding
Good News! The cause of your bleeding can usually be
diagnosed in one or two office visits!
First, I get a history of the problem, and do a routine pelvic exam.
But many causes of bleeding can be missed by exam alone. Therefore I routinely do an
ultrasound examination at the time of the first visit. Vaginal probe ultrasound only takes a
few minutes, is not uncomfortable, and rapidly provides invaluable information.
I feel it is important to do my own ultrasound, as I have often found things that
were missed when the ultrasound was done by someone with less experience.
Frequently the diagnosis can be made on the basis of the exam and ultrasound.
Depending on the findings, other tests may be
necessary at a second visit.
It may be helpful to look inside the uterus with a slender telescope
called a hysteroscope that is inserted through the cervix.
I do most diagnostic hysteroscopy in the office using local anesthesia.
If you are particularly anxious, or if there is a concern about
discomfort, I can do hysteroscopy with mild sedation. To
me, the ability to be able to see into the uterus in a quick office procedure is
as basic to gynecology as is looking in an ear to an ear specialist.
Once the cause of bleeding is identified, we discuss all of the treatment
options available. Sometimes there can be heavy bleeding even if the
uterus appears normal, but this also can be treated once we have eliminated
other causes.
Click here to read about
treatment options for heavy bleeding.
