When not to go with the flow: Putting an end to endless periods

Women who haven’t reached menopause yet are accustomed to menstrual bleeding and might not be surprised by some unexpected spotting. However, it’s a good idea to talk to a doctor if you notice vaginal bleeding during unexpected times, if menstrual bleeding goes on longer than 7 days, or if you experience heavier periods or pain. If your period stopped for 12 months or more, signaling menopause, bleeding after that time is considered abnormal.

Heavy periods are not the norm. If it’s too much (more than 1/3 cup), too frequent (21 days or less) or too long (more than 7 days), it’s time to talk to your doctor. For women in their 40s and 50s, the years before menopause and the transition into menopause might bring uncertainty about what’s normal. It’s important to rule out other causes of abnormal bleeding such as fibroids and uterine cancer.

Abnormal bleeding can affect your quality of life, disrupting your sex life, travel, sports activities and body image. It can also cause pain, fatigue and anemia. It may raise your risk of endometriosis (lining of the uterus growing on other organs like the fallopian tubes and ovaries) and cancer.

Your doctor can guide you in finding answers, but the most common tests include a pap smear, lab work to check for anemia and hormonal imbalances, and, in some cases, a biopsy.

A biopsy of the endometrium (the lining of the uterus) can be done at the gynecologist’s office. A small straw is inserted into the uterus and a sample is collected and sent to a lab for testing. A hysteroscopy, to look inside the uterus with a small camera, can also be performed by a gynecologist.

One common cause of abnormal bleeding is the formation of fibroids. These are benign tumors made of cells from the uterus. About one-third of women of reproductive age develop fibroids, and more than 70 percent of women in their 50s have them. They are a primary cause of pain, pressure and heavy periods, and the most common cause for the removal of the uterus (hysterectomy) in the U.S.

Other causes of abnormal bleeding or of missed periods include polycystic ovary syndrome, polyps, or precancerous problems. Minimally invasive procedures are available for several of these conditions and the recovery times are shorter than with traditional surgeries.

Talk to your doctor if heavy periods, pain or abnormal bleeding are disrupting your day to day life. There are options to help you resume your normal activities and live pain-free.

To learn more, join Dr. Wechter at the Y Healthy Living Center in Mandarin on March 15 to discuss symptoms and treatment options for abnormal bleeding. https://www.eventbrite.com/e/talk-with-a-doc-tickets-21671908261

Mary Ellen Wechter, MD, MPH is a gynecologist with North Florida OB/GYN, practicing at Baptist Jacksonville and in Mandarin. Dr. Wechter specializes in fibroids, abnormal bleeding, vulvar diseases, and the use of laparoscopy, hysteroscopy and robotics (minimally invasive gynecologic surgery) for the treatment of noncancerous gynecologic problems.

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