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Are You Having Abnormal Bleeding?

Cervical Cancer

What is abnormal uterine bleeding?

Abnormal uterine bleeding would be defined as any bleeding that occurs between normal periods. This could be the result of some "hormonal imbalance," or it can be the result of some abnormality in terms of pathology, such as polyps, fibroids, precancerous or even occasionally cancerous.

How does a woman know that it is time to see a doctor about bleeding in between her periods?

A woman over the age 35 who has abnormal uterine bleeding must be evaluated according to the guidelines of the American College of Obstetricians and Gynecologists. Common sense would dictate that if there is a one-time occurrence which does not repeat itself this should not be a cause for alarm. However, anything beyond should cause a woman to seek evaluation from her physician.

Does abnormal bleeding signify a more serious underlying condition in women?

Abnormal uterine bleeding can absolutely be a sign of a more serious underlying condition, including uterine cancer. However, uterine cancer can present without abnormal uterine bleeding as well as precancerous changes. Other conditions that are not life threatening, but can be anatomically abnormal, such as fibroids or polyps, can result in abnormal bleeding as well. Finally, even if the abnormal bleeding is from "hormone imbalance," such imbalances may represent other hormonal problems and would require evaluation by a physician.

How can a woman go about getting tested for abnormal uterine bleeding?

A woman with abnormal uterine bleeding should go to her gynecologist. In the past, often the first step was an endometrial biopsy. More current information has shown that blind endometrial biopsy gets a very small portion of the uterine tissue and may be fraught with error. A more modern approach is employing transvaginal ultrasound and a test called saline infusion sonohysterography, whereby a small amount of saline can be instilled into the uterus during a simple transvaginal sonogram. This may be a more reliable first step in the evaluation of abnormal uterine bleeding. Such a test is virtually painless and can be performed by most gynecologists utilizing ultrasound, which is a safe and common technique.

What can women do to protect their reproductive health and prevent abnormal bleeding?

Protecting reproductive health best comes from avoiding sexually transmitted diseases and practicing safe sex. Preventing abnormal uterine bleeding may be a bit more difficult. In very rare instances it might be related to diet or medication and/or weighing too much or weighing too little, but the overwhelming majority of abnormal uterine bleeding cases are not necessarily preventable. When they do exist, abnormal uterine bleeding should be recognized promptly and treated appropriately.

For more information visit Dr. Goldstein's Web site.

Copyright © 2014, The Baltimore Sun
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