Abnormal Bleeding

A normal menstrual period generally lasts up to 8 days. Bleeding in between periods, after sex or after menopause are considered abnormal uterine bleeding. Longer or shorter menstrual cycles (longer than 38 days or shorter than 24) or heavy bleeding during your period are also indicate irregular bleeding and require attention. Abnormal bleeding from the uterus can be caused by a wide variety of local and systemic conditions, or it can be related to medicines use.

What are the possible causes?

Common causes are ovulation problems, presence of fibroids or polyps, etc. Irregular bleeding may also be due to underlying pathology, such as cervicitis, pelvic inflammatory disease, endometriosis, or a certain type of cancer.

In most cases, irregular bleeding is common in the first three to four months of combined oral contraceptive pill (COCP) use. Women using progestogen-only contraceptive methods experience the bleeding due to a relatively atrophic, unstable endometrium.

Long-acting reversible hormonal contraceptives (LARCs), particularly, in the case of hormonal IUDs, heavy bleeding is common. But when accompanied by pain it indicates mal-position of the device.

Diagnosis

Establishing the source of bleeding is an essential first step when assessing women. At Sparrsh Clinic, our ob-gyn or other health care professionals will carefully study your medical history combined with gynecological examination and appropriate tests.

Our doctor will start by checking for problems most common in your age group. Some of them are not serious and are easy to treat. Based on your condition you may require blood tests, Ultrasound exams, Hysteroscopy, Sonohysterography, Magnetic resonance imaging (MRI), etc. Test results will indicate the cause of bleeding, and our doctor will recommend an appropriate management plan.

Management

Medications including birth control pills, anti-inflammatory drugs, antibiotics, or other hormonal drugs are usually recommended as a first line of treatment.

If abnormal/irregular bleeding is determined to be secondary to contraceptive use, management will include use of the alternate methods.

For the majority of women using the contraceptive injection or the levonorgestrel IUD, irregular bleeding settles over time and long-term use of additional hormonal contraception is rarely required. Women sometimes report more irregular bleeding when the implant or IUD approaches the recommended time for removal.

If medication does not reduce your bleeding, a surgical procedure may be needed. The type of surgery will depend upon your condition and age.

At Sparrsh Clinic, Dr. Preeti Singh has been practicing women care for more than 11 years. She has expertise in the fields of IUI, normal vaginal delivery, high-risk pregnancy care, gynecological problems as well as infertility treatments.