Abnormal Uterine Bleeding

Abnormal uterine bleeding is a term which refers to menstrual bleeding of abnormal quantity, duration or schedule. There can be many causes but most are related to problems with ovulation or structural changes of the uterus.

Ovulation occurs when an egg is released from the ovary each month. Communication from your brain to your ovary through hormones allows this to happen. Structural changes refer to abnormal growths in the uterus such as fibroids or polyps or less commonly cancer. Additionally, other sources could be related to medications or an underlying problem of the blood system.

There are multiple ways to identify the cause of bleeding. The first step is always a physical exam with your OB-GYN. From a simple blood draw, we can check for pregnancy, hormone levels, bleeding disorders, anemia and low iron levels. Sometimes an endometrial biopsy may be necessary, this samples the tissue of the lining of the uterus to rule out pre-cancers and cancers. An ultrasound or sonogram can also be performed to further evaluate structural changes of the uterus. We conveniently offer all of these services at our Capital Women's Care Bethesda office and oftentimes these will be performed the same day as your visit. 

Treatment is catered to the underlying cause. If the cause is due to dysfunctional ovulation, hormonal medications or an intrauterine device can help to lighten periods or stop them completely. Surgery may be an option if the bleeding is structural in nature or if medications have not improved the symptoms. This can sometimes be completed with an outpatient procedure called hysteroscopy. During a hysteroscopy a thin telescope like device is inserted through the vagina and cervix. A camera allows visual inspection of the inside of the uterine cavity for any anatomic reasons for the abnormal bleeding. Along with its diagnostic properties, certain hysteroscopes are equipped with the ability to remove small fibroids or polyps. If the problem cannot be solved with hysteroscopy alone there are other surgical procedures that can treat the abnormal bleeding.

If you are having abnormal uterine bleeding our providers at Capital Women's Care Bethesda can help. Please take advantage of our online scheduling features or our guaranteed same day appointments to schedule a consultation with one of our specialists. We are here to serve your health care needs!

Rachael Cleberg MD MPH

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