Need a Gynecologist right away? Vaginal bleeding?

Irregular Periods or Heavy Bleeding – What should I do?

Are you suffering from wondering when your period will ever stop? Don’t worry! You are not alone. According to UpToDate a survey of women ages 18-50 in America showed 53 per 1000 females reported abnormal uterine bleeding (AUB).

AUB can be caused by many different factors including, but not limited to: structural abnormalities, hemostasis disorder, neoplasia, ovulatory dysfunction. The most important items to consider first are: pregnancy status, age, and location of the bleed.

With girls, it is very common to mistake a bleed from the lower genital tract, the urinary tract, or the GI tract for a uterine bleed. It is helpful to note whether the bleeding occurs only with urination and/or defecation. Another way to distinguish where the blood is coming from is to dab each orifice separately. If you notice blood after intercourse, it is likely from the cervix. Heavy bleeding is usually from the uterus.

What to expect from visiting your gynecologist:

  • AUB in a 15 year old girl → usually PCOS or menarche
  • Pregnancy test: bleeding can still occur while pregnant. This is also done to rule out an ectopic pregnancy
  • Hormone panel: to detect PCOS or menarche
  • Sonogram: to detect structural abnormalities or PCOS
  • Coagulopathy workup including PT/PTT
  • TSH levels for hypothyroidism workup

 

  • AUB in a 35 year old woman → usually thyroid dysfuction or fibroids
  • Pregnancy test: bleeding can still occur while pregnant. This is also done to rule out an ectopic pregnancy
  • Hormone panel: to detect PCOS
  • Sonogram: to detect PCOS or fibroids
  • TSH levels: to detect thyroid dysfunction

 

  • AUB in a 55 year old woman → perimenopause or neoplasia
  • Hormone panel: to detect menopause
  • Biopsy if post menopausal bleed to rule out endometrial cancer
  • Sonogram: to detect structural abnormalities
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