Abnormal Bleeding

Women First Care
Through every stage of life

woman in black shirt smiling
Stethoscope Icon


Icon of Lotus Florwer


Pelvic Helath Icon


Menopause & Hormones

Diagnostics & Treatment

Uterus Icon to Represent Gynecologic Surgeries

Gynecologic Surgeries

If you’ve experienced bleeding or spotting between periods, you have plenty of company. Many women experience this at various times in their lives. Uterine bleeding is considered abnormal if it happens when you are not expecting a menstrual period or when menstrual flow is lighter or heavier than normal. It is also considered abnormal if it occurs during a life stage when it is unexpected, such as before 10 years of age, during pregnancy or after menopause.

There are many possible causes for abnormal bleeding and, while it doesn’t necessarily mean you have a serious condition, it is reason to call and visit your health care provider. Any bleeding during pregnancy, or a possible pregnancy, needs to be evaluated and warrants a call to your doctor’s office immediately. Ovulation can cause bleeding mid-cycle between menstrual periods. Perimenopause, the time of hormonal fluctuations leading up to menopause, is often typified by irregular uterine bleeding as menstrual changes occur prior to menopause. Bleeding between periods, excessive menstrual flow, and either more frequent or missed periods are all common symptoms of perimenopausal bleeding changes.

Other reasons for irregular bleeding can include uterine fibroids, uterine polyps, adenomyosis, uterine hyperplasia, and uterine cancer. These problems can be evaluated by a pelvic exam, a pelvic ultrasound, an endometrial biopsy and, if needed, a dilation and curettage procedure (D& C) with hysteroscopy.

Treatments for Abnormal Bleeding

For women not taking hormonal contraceptives, a common reason for abnormal bleeding is due to changing hormonal levels that prevent ovulation from occurring during some cycles. Regular, but much heavier, periods are very common in later reproductive years before menopause—a time period called perimenopause. The good news for women in their 40s is that a low dose birth control pill can control bleeding problems and alleviate some of the other symptoms of perimenopause, including hot flashes, night sweats, premenstrual syndrome and even premenstrual headaches when used on a continuous basis. At menopause, hormone replacement therapy (which provide lower doses of estrogen and progesterone than the pill) can begin, often weaning off hormones altogether as the symptoms of menopause allow.

If you can’t or prefer not to take birth control pills, you may benefit from other conservative methods to control bleeding. The progestin IUD (intrauterine device) is one of these options, and it provides an excellent form of birth control lasting for five years. The device releases a progesterone-like hormone which works to thin the lining of the uterus, resulting in much lighter periods. The IUD is an especially good option for women who need a reversible form of contraception.

Endometrial ablation is a minimally invasive procedure that works well to treat heavy bleeding during perimenopause, and may even help some patients avoid a hysterectomy. Ablation procedures scar the uterine lining, and they are highly successful in decreasing the amount of bleeding, in some cases stopping periods altogether. This procedure is not a birth control method and is only for women who have completed childbearing.

For women who have been unsuccessful with medical management and less invasive options, a hysterectomy may be the best option for abnormal bleeding. A hysterectomy is the most definitive treatment for abnormal bleeding and may be preferred for women with significant fibroids, adenomyosis and endometriosis.

Is it Time to Schedule Your Annual Wellness Exam?

Your annual women’s health appointment is a vital part of your health care, and the perfect time to talk to your Care Team about your personal health questions.

Is it Time to Schedule Your Annual Wellness Exam?

What People Are Saying

Alina Zabelle
Alina Zabelle
Got me that day very professional clean environment
Lisa Webb
Lisa Webb
Dr. Miller is my doctor and I can't say enough good about her and any of the staff I have interacted with. I highly recommend them.
Tiffany Enriquez
Tiffany Enriquez
I love Dr. Brown. Hands down, she is an Angel on Earth. I literally would not be here today without her. She always tells me exactly what I need to hear, she stands up for her patients, and has believed in me when I don’t believe in myself. Woman’s health isn’t just gynecological. It’s mental. It’s having someone there to hold your hand when you’re alone. And Dr. Brown continues to hold my hand and I can’t thank her enough. I will forever be indebted to her and will love her forever. I will miss her incredibly and deeply when she retires. Thank you Dr. Brown, for everything. -Tiffany Enriquez
Willa S. Tierney
Willa S. Tierney
Only positive things to say about Women’s First! I always receive excellent communication from support staff and I’m very grateful for the doctor-patient relationship I have with Dr. Rebecca Booth. I frequently speak highly of and recommend this practice to friends, family, and colleagues!
Yoselin Ramirez
Yoselin Ramirez
La doctora margarita terraza aun trabaja ahí?