IMG_2232What is abnormal bleeding?

This is a question that many struggling women ask.

No one likes to have bleeding at all; however, there are parameters that gynecologists use to assess what is “abnormal.”

Abnormal bleeding is any period lasting longer than 7 days, closer than 21 days apart or further than 35 days apart. It also includes bleeding that is abnormally heavy.

A heavy period is usually one that puts a significant amount of stress on the body. If you are changing a pad or tampon every hour, that is too heavy. Every two hours is even a little too heavy. Over a period of time, this can lead to anemia. “Normal” is probably changing a pad or tampon every 3­-4 hours. Bleeding after intercourse is abnormal as well and should be evaluated by your gynecologist.

There are many women whose periods would meet the criteria for abnormal. Does this mean that they should rush to the gynecologist? No. In most circumstances, if a woman has abnormal bleeding and is not bothered by it, we do not intervene. However, you should discuss this with your gynecologist to make sure that your abnormal bleeding is not a sign of something more serious. Only your medical provider that specializes in gynecology can make this determination.

At different times in our lives, abnormal bleeding can be expected.

But again, only your doctor can decide if yours is benign. We take many factors into consideration when we make this determination. When a girl begins to menstruate, it is not unusual for the periods to be irregular and heavy. However, excessive bleeding in these years can contribute to fatigue and poor school performance. The perimenopause time (ages 35-­55) is also a period of expected changes in your cycle.

Once a determination is made to the cause of the abnormal bleeding, the bleeding can be treated. The cause of the bleeding determines the treatment offered. There are many minimally invasive approaches to treat bleeding that have developed over the last 30 years. Many women feel that heavy bleeding is just part of being a woman, and therefore they should just put up with it. Having a cycle is part of being a woman, but the inability to leave your house for 2 days per month is not!  Talk to your gynecologist about options.

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