If you are experiencing abnormal vaginal bleeding, you should contact a gynecologist and schedule a pelvic exam to detect any serious implications as early as possible. Lab tests will help determine the cause of your condition. Doctors will order tests to rule out certain bleeding disorders, pregnancy, or sexually transmitted infections (STIs).
Diagnosing Abnormal Uterine Bleeding
A doctor will first meet with you to discuss your menstrual history to determine whether abnormal bleeding is related to your age or a possible infection. A pelvic exam and pap smear will be conducted as part of the diagnostic testing.
Tests and imaging
After an initial meeting with your gynecologist, additional testing for abnormal uterine bleeding may include:
- Ultrasound – An exam that uses sound waves to produce a picture of the pelvic organs
- Hysteroscopy - Involves a thin, lighted scope that’s inserted through the vagina and the opening of the cervix, allowing your ob-gyn to view the interior of the uterus
- Endometrial biopsy - A sample of the endometrium tissue is examined for possible cancerous cells
- Sonohysterography - A safe and painless procedure that injects fluid into the uterus via a thin tube while ultrasound images of the uterus are produced
- Magnetic resonance imaging (MRI) – An MRI uses powerful magnets to create images of the internal organs
- Computed tomography (CT) - A type of X-ray procedure that shows internal organs and structures in cross-sections
Treatment Approaches for Abnormal Uterine Bleeding
Depending on the outcome of the preliminary tests, the cause of abnormal uterine bleeding will be determined and your doctor will discuss a treatment approach with you. Abnormal uterine bleeding treatments may include medications or surgical options to manage and treat the underlying cause of bleeding.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), help reduce pain sometimes associated with excessive menstrual blood loss
- Oral contraceptives are sometimes used to help regulate menstrual cycles and reduce prolonged, excessive menstrual bleeding
- Hormonal IUDs contain the hormone progesterone and work to correct hormone imbalance. In turn, this can reduce excessive uterine bleeding
Most cases of abnormal uterine bleeding can be treated without surgery. However, if nonsurgical therapies prove to be unsuccessful, surgical procedures are another option for treating abnormal uterine bleeding.
- Dilation and curettage (D&C) is a procedure that involves the dilation of your cervix. Tissue from the uterine lining is then scraped or suctioned to reduce menstrual bleeding
- Uterine artery embolization is used to treat fibroids by decreasing the blood supply to the fibroids, thus shrinking their size and decreasing excessive bleeding
- Focused ultrasound surgery, like artery embolization, treats fibroids by shrinking them using ultrasound waves, which destroy the fibroid tissue. No incisions are necessary for this procedure.
- A myomectomy requires the surgical removal of fibroids either through several small incisions through the abdomen (laparoscopically), the vagina, or the cervix (hysteroscopically)
- An endometrial ablation destroys the lining of the uterus using a laser, radiofrequency, or heat to destroy the tissue. This procedure is only used when women do not plan to have any children in the future.
- A hysterectomy is a surgical procedure to remove the uterus. Patients will no longer be able to get pregnant after this operation.
Receive Treatment for Abnormal Uterine Bleeding at NewYork-Presbyterian
Find a gynecologist at one of NewYork-Presbyterian’s many locations throughout the New York metropolitan area. NewYork-Presbyterian offers a wide range of surgical and nonsurgical gynecological services for abnormal uterine bleeding.