Abnormal bleeding can be a worrying experience, but it’s something I see in my clinic all the time. This guide will help you understand what might be causing it and how we approach diagnosing it. Remember, if you’re experiencing abnormal bleeding, it’s important to speak with your doctor.

1. Abnormal Bleeding in Adolescents (Teenagers)

Why does it happen?

• In teenagers, the brain, ovaries, and uterus may not yet communicate efficiently, which we call an immature HPO axis.
• This can result in irregular or heavy periods.

What can help?

• Keeping a menstrual journal or using a period-tracking app can help monitor patterns.
• If irregular bleeding continues past age 16, further evaluation might be needed.

2. Abnormal Bleeding in Reproductive Years (20s to 40s)

Common Causes:

• Polyps and fibroids (non-cancerous growths)
• Polycystic ovary syndrome (PCOS)
• Infections or pregnancyBleeding disorders

What to do:

If you’re in your reproductive years and notice abnormal bleeding, it’s important to rule out these causes with a doctor.

3. Abnormal Bleeding in Post-Menopausal Years

Red flags to watch for:

• Bleeding after menopause is never normal and should always be investigated.
• Possible causes include endometrial or cervical cancer, though benign causes like polyps or fibroids can also occur.

What should be done?

If you experience any post-menopausal bleeding, seek medical help immediately.

4. How We Diagnose Abnormal Bleeding

When you see your doctor, here’s what you can expect during your visit:

1. Patient History
• Your doctor will ask about the nature of your bleeding, its frequency, and how much blood you’re losing.
2. Physical Exam
• A pelvic exam may be done to check for growths like fibroids.
3. Blood Work
• Blood tests may include checking for conditions like PCOS or thyroid disorders.
4. Imaging Tests
• The gold standard for imaging is a transvaginal ultrasound, but if that’s uncomfortable, a transabdominal ultrasound may be used.

5. Why You Should See Your Doctor

Abnormal bleeding can greatly affect your quality of life. The sooner you address it, the sooner you can find relief. Your OBGYN can help determine the root cause and recommend the right treatment.