As an individual, you may have a different consistency, length and time span of bleeding during your period. This can depend on factors like age, weight, genetics and medical conditions. However, if you experience irregular or abnormal bleeding, do you know when to contact your provider?
What is abnormal bleeding?
Abnormal bleeding is considered anything outside of what we consider a “normal period,” said Dr. Rebecca Downs, OB/GYN physician with Marshfield Clinic Health System. Some examples include bleeding in between your normal cycle, a cycle that lasts shorter or longer than a normal cycle length (21-35 days), or heavy bleeding that causes a woman to pass large clots, change a pad or tampon frequently like every hour, or even bleeding that soaks through a pad or tampon and clothes during the day or overnight.
Downs explains that any time you feel that something isn’t right – contact your provider. In addition, she advises if you have bleeding after menopause, you should schedule an appointment with your women’s health provider.
“We always like to rule out the ‘bad stuff,’” Downs said. “This is especially important for post-menopausal women.”
What causes abnormal bleeding?
Downs explains that causes of abnormal bleeding can sometimes differ depending on a person’s age.
In younger women, abnormal bleeding can be from a bleeding disorder or irregular periods that have been “inherited.” In reproductive women, bleeding can come from structural abnormalities, such as an endometrial polyp or uterine fibroid, from adenomyosis (a benign condition of endometrial glands growing into the uterine muscle), or more rarely, from an endometrial pre-cancer or cancer.
“If you are having irregular bleeding or heavy bleeding that is bothersome, or very painful periods, all of those are reasons to contact a provider,” Downs said.
Some common conditions cause abnormal bleeding and those conditions have treatment options available for improved quality of life.
Uterine fibroids are a growth in the muscle of the uterus and are common in women. According to the Department of Health Services, up to 80% of women develop fibroids by the time they reach 50 years old. Downs said they are more common in women 40 and above, but can be present in women of all ages. Some ethnicities, like being an African American woman, also are more prone to fibroids.
“Fibroids are usually benign, but sometimes, can be more concerning,” Downs said.
Depending on the size, amount and location of fibroids, heavy menstrual bleeding and painful periods can occur. In addition, fibroids can cause pelvic pressure and urinary concerns if large enough.
Treatment options can include treating the bleeding with medication or myomectomy, which is removal of the fibroid, or hysterectomy, which removes the uterus but usually saves the ovaries in the process. Downs said treatment depends on what you want to do, as well as the type and size of the fibroids.
Uterine or endometrial polyps
Uterine, or sometimes called endometrial polyps, are small little outpouchings or growths that can develop in the uterine lining and often cause irregular bleeding for women. In most cases, the polyps are benign.
“We often spot them on a pelvic ultrasound in women who were having bleeding irregularities,” Downs said.
The polyps can be easily remove with minor outpatient surgery called hysteroscopy, which is a scope that can be used inside the uterus to remove the polyp.
Beyond controlling the inconsistency of bleeding that is disrupting your life, your provider will make sure that the abnormal bleeding isn’t something more concerning.
Abnormal bleeding can be a symptom of endometrial or uterine cancer. With an ultrasound exam, your provider can make the determination for further testing. Endometrial cancer is usually treated with surgery. Additional treatment may be needed once the stage of the disease is determined, according to the American College of Obstetrics and Gynecologists.
Your women’s health provider can help
Contact your provider if you have any bleeding concerns or questions about your overall health.
“Abnormal bleeding will affect a woman’s quality of life,” Downs said. “No need to suffer in silence, we have many safe treatment options to help you.”