I often have trouble summarizing “heavy bleeding” in a 30 minute appointment. This is going to be a very short summary, about a very complicated topic.  Hopefully you find it helpful to start simple and we can build from there.

Often times we do not find specific reasons for heavy/irregular bleeding. We will make sure it is nothing serious (cancer, infection, ect); everything else can be treated as stated below.  

Causes:

1. Hormone imbalance
2. Anovulation (often from hormone imbalance)
3. Infection
4. Unknown
5. Structural problems
   1. Polyps
   2. Fibroids
   3. Thick endometrium
   4. Hyperplasia
   5. Endometriosis/Adenomyosis
   6. Cancer/precancer

Periods can change over a life time, sometimes we find the reason, sometimes we don’t.  These things have been shown to cause changes in our mensural cycles: stress, change in what we are eating, weight loss, weight gain, increase in activity, decrease in activity, new sexual activity, new relationships, pregnancy, age.

Treatment:

Once we rule out hormonal problems, infection, and cancer we can start treatment. Treatment is simple.

1. Hormones
   1. Oral birth control
   2. IUD, Nexplanon
   3. Patches, Nuvaring
   4. Shot-Depo-provera
2. Antihormones
   1. Lysteada:  helps your uterus clot.
   2. Lupron: medication that puts you into a fake/temporary menopause.
3. Surgery
   1. Ablation
   2. Hysterectomy
   3. Uterine artery ablation (we don’t do this in Tillamook, this is something interventional radiology does not gynecologists)