Abnormal bleeding is considered any bleeding outside the expected menstrual cycle and may be abnormally frequent, lasting excessively long, heavier than normal or irregular. While slightly different, postmenopausal bleeding is also considered abnormal and should always be promptly evaluated.
Pelvic ultrasound (abdominal and transvaginal) is frequently used to determine the cause of abnormal bleeding. Other testing may include vaginal swabs to rule out infection and endometrial biopsy. A pelvic exam is also included in evaluation of abnormal bleeding.
There are some instances of abnormal bleeding when a procedure or surgery may be recommended, such as endometrial polyps, uterine fibroids, and ovarian cysts/masses. Sometimes hormones may be recommended, including a progesterone IUD insertion. All final treatment plans include a personalized discussion of potential management options and their associated risks/benefits.