Gynaecological Treatment - ovarian cyst

The normal length of the menstrual cycle is typically between 21 and 35 days. A normal menstrual period generally lasts up to 7 days.  

When is bleeding abnormal? 

• Bleeding in any of the following situations is considered abnormal uterine bleeding:  
• Bleeding or spotting between periods.
• Bleeding or spotting after sex.
• Heavy bleeding during your period.
• Bleeding that soaks through one or more tampons or pads every hour.
• Bleeding that lasts more than 7 days.
• Menstrual cycles that are longer than 35 days or shorter than 21 days.
• “Irregular” periods in which cycle length varies by more than 7 to 9 days.
• Not having a period for 3 to 6 months.
• Bleeding after menopause.

What causes abnormal uterine bleeding?

Abnormal uterine bleeding can have many causes, including a variety of medical conditions and even stress:

Hormone imbalances

• Anovulation.
• Thyroid disease.
• Polycystic ovary syndrome (PCOS).

Weighing more than your ideal body weight can lead to hormone imbalances that may cause abnormal uterine bleeding, too.

Structural abnormalities in your uterus

• Polyps.
• Fibroids.
• Adenomyosis.
• Endometriosis.

Precancer and cancer

• Uterine cancer.
• Cervical cancer.
• Vaginal cancer.
• Ovarian cancer.
• Endometrial hyperplasia.

Infections

• Trichomoniasis.
• Cervicitis.
• Chlamydia.
• Gonorrhea.
• Endometritis.
• Vaginitis.

Other medical conditions

• Von Willebrand disease.
• Liver disease.
• Kidney disease.
• Pelvic inflammatory disease (PID).
• Leukemia or platelet disorders.

Medications

• Blood thinners.
• Hormone replacement therapy.
• Tamoxifen (breast cancer drug).
• Intrauterine devices (IUDs).
• Birth control pills and injectables.

When to see a doctor  

If you're pregnant, contact your doctor immediately if you notice vaginal bleeding.  

In general, anytime you experience unexpected vaginal bleeding, consult your doctor. Whether or not vaginal bleeding is normal depends on your age and the circumstances.  

If you are experiencing bleeding that is interfering with your day to day activities or lifestyle.

Postmenopausal women not taking hormone therapy should see a doctor if they experience vaginal bleeding. 

Postmenopausal women taking cyclic hormone therapy may experience some vaginal bleeding. If bleeding persists longer or heavy bleeding begins, see your doctor. 

Girls who don't have any other signs of puberty or are younger than age 8 should have any vaginal bleeding investigated.

The following situations are likely normal, but talk to your doctor if you're concerned:  

Newborn girls may have some vaginal bleeding during the first month of life. 

Bleeding that's excessive or lasts longer should be checked out. 

Adolescent girls who have just begun having periods may experience irregular cycles during the first few years. 

In addition, many girls and women have light spotting for a few days before menstruating. 

Women starting birth control pills may experience occasional spotting the first few months. 

Women nearing menopause (perimenopause) may experience increasingly heavy or irregular periods. 

Ask your doctor about possible treatments to minimize your symptoms.

What to expect during your visit  

In addition to a detailed interview about your bleeding, your personal health history and your family history, your doctor may ask you to keep a diary of your bleeding and other symptoms.

You should have a physical exam, including a pelvic exam. Lab tests may be done. A blood test called a complete blood count (FBC) can help determine if you have anaemia or an infection. 

You may have tests for certain bleeding disorders. 

You may have a pregnancy test and tests for sexually transmitted infections (STIs).  

Based on your symptoms and your age, other tests may be needed:  Ultrasound exam. Ultrasonic waves are used to make an image of the pelvic organs.  

Hysteroscopy. A thin, lighted scope is inserted through the vagina and the opening of the cervix. It allows your doctor to see the inside of the uterus.  Endometrial biopsy—A sample of the endometrium is removed and looked at under a microscope.  

Sonohysterography. Fluid is placed in the uterus through a thin tube while ultrasound images are made of the uterus.  

Magnetic resonance imaging (MRI)—This imaging test uses powerful magnets to create images of the internal organs.  

Computed tomography (CT).This X-ray procedure shows internal organs and structures in cross section.

Your treatment depends on what’s causing your bleeding. Medications and surgical options are available to manage your bleeding or treat what’s causing it.