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Abnormal or Excessive Menstrual Bleeding

Excessive menstrual bleeding can happen for different reasons. Hormonal imbalance and uterine growths are two of the most common causes.

Hormonal Imbalances

Your menstrual cycle is controlled by hormones, including estrogen and progesterone. When they are out of balance, these same hormones can cause heavy periods or bleeding between periods. Causes of hormonal imbalances may include:

  • Hormonal changes in teens and women nearing menopause
  • Diabetes, thyroid disease or other medical problems
  • Obesity
  • Stress
  • Strenuous exercise
  • Anorexia (an eating disorder)

Types of Uterine Growths:

  • Fibroids are round “knots” of uterine muscle tissue.
  • Adenomyosis occurs when cells of the uterine lining grow into the muscle wall.
  • Polyps are small growths of tissue from the uterine lining that grow inside, and often hang into the uterus.
  • Hyperplasia is an overgrowth of the uterine lining.
  • Endometrial cancer is an uncontrolled growth of cells of the uterine lining in the abdomen.

Treatment Options for Excessive Menstrual Bleeding

Excessive menstrual bleeding can be treated with hormone therapy, surgery or a combination of both options.

Hormone Therapy

Hormone therapy regulates or blocks the hormones that control your menstrual cycle. This means it can limit the swelling of your endometrium and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery. The following are different types of hormone therapies:

GnRH agonists, as well as FSH and LH inhibitors, stop or lower the production of estrogen and progesterone hormones.
Birth control pills contain estrogen and progesterone. They can help to regulate the levels of estrogen and progesterone in your body.
Progestins, a form of progesterone, help keep estrogen levels low.
Danazol® is a hormone that stops or lowers the production of estrogen and progesterone.

Surgery

Surgery can be used to remove uterine growths or for a more definitive treatment, to remove the uterus itself. Surgical procedures include endometrial ablation, myomectomy and hysterectomy.

Hysterectomy is the surgical removal of your uterus. Depending upon your condition, your fallopian tubes, ovaries and other growths in your pelvic cavity may also be removed.
Endometrial ablation is a medical procedure that uses energy to destroy the endometrial lining of a woman’s uterus. This technique is most often employed for women who suffer from excessive or prolonged bleeding during their menstrual cycle and is most commonly done on an outpatient basis. Endometrial ablation is contraindicated in patients who may want to get pregnant.
Myomectomy is the surgical removal of the uterine fibroid growths. These can be removed successfully with a robotic laparoscopic procedure or hysteroscopicly if the fibroid extends into the uterine cavity.