Evaluation of Abnormal Bleeding
The normal menstrual cycle lasts 2-7 days and occurs every 3-5 weeks. Bleeding that occurs between cycles, is heavier than normal, or happens after menopause requires further evaluation.
The most common causes of abnormal vaginal bleeding are:
- Hormonal imbalances – due to thyroid problems, lack of ovulation, or menopause
- Growths in the uterus or on the cervix – such as fibroids, polyps, uterine cancer, cervical cancer
- Vaginal infections – such as yeast, bacterial vaginosis, chlamydia
At the visit with your doctor, you may be asked about your normal cycles, when the abnormal bleeding began, whether you are using any hormones, and your sexual history. If you are premenopausal, your doctor will check a pregnancy test. You may also have a complete pelvic exam, testing for vaginal infections, an ultrasound, or a uterine biopsy.
The treatment of abnormal vaginal bleeding depends on its cause. When an infection is identified, it will be appropriately treated. If a growth or tumor is found, it can be removed. Hormonal changes can be treated with hormone replacement or birth control pills. In some cases, no treatment is necessary and the condition will resolve on its own. Your doctor will discuss options with you at length so you can make an informed decision.