Vaginal Bleeding

Heavy menstrual bleeding or Menorrhagia is seen in 10% of ovulating women. This can occur due to the following reasons:-

• Endometrial polyps

• Uterine fibroids

• Adenomyosis

• Hypothyroidism

• Systemic lupus erythematosus

• Blood clotting disorders

• Intrauterine devices (IUD)

• Certain medications

• Endometrial hyperplasia and endometrial cancer (women > 40 years)

Menorrhagia can give rise to severe cramps and can lead to anemia, fatigue, dizziness and fainting attacks due to low hemoglobin  which can be highly distressing.To rule out the above causes of bleeding, a thorough evaluation is required. It can includes investigations such as ultrasound – abdominal and trans-vaginal, Hormonal profile, thyroid function tests, clotting parameters. Sometimes PAP smear, an endometrial biopsy or dilatation and curettage with biopsy of the endometrial material. All this is done mostly to rule out the possibility of cancer..

In some women with dysfunctional uterine bleeding no definite cause can be found however appropriate treatment can effectively control the bleeding.