Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Normal vaginal bleeding is the periodic blood that
flows as a discharge from the woman's uterus.
Normal vaginal bleeding is also
called menorrhea. The process by which menorrhea occurs is called
In order to determine whether bleeding is abnormal,
and its cause, the doctor must answer 3 questions: Is the woman pregnant? What
is the pattern of the bleeding? Is she ovulating?
Abnormal vaginal bleeding in women who are ovulating
regularly most commonly involves excessive, frequent, irregular, or decreased
There are many causes of abnormal vaginal bleeding
that are associated with irregular ovulation.
A woman who has irregular menstrual periods requires
a physical examination with a special emphasis on the thyroid, breast, and
Treatment for irregular vaginal bleeding depends on the underlying cause.
After the cause is determined, the doctor decides if treatment is actually
What is normal vaginal bleeding?
Normal vaginal bleeding is the periodic blood that flows
as a discharge from
the woman's uterus. Normal vaginal bleeding is also called menorrhea. The
process by which menorrhea occurs is called
Normal vaginal bleeding occurs as a result of cyclic
hormonal changes. The ovaries are the main source of female hormones, which
control the development of
female body characteristics such as the
breasts, body shape, and body hair. The
hormones also regulate the menstrual cycle. The ovary, or female gonad, is one of
a pair of reproductive glands in women. They are located in the pelvis, one on
each side of the uterus. Each ovary is about the size and shape of an almond.
The ovaries produce eggs (ova) and female hormones. During each monthly
menstrual cycle, an egg is released from one ovary. The egg travels from the
ovary through a Fallopian tube to the
Unless pregnancy occurs, the cycle
ends with the shedding of part of the inner lining of uterus, which results in
menstruation. Although it is actually the end of the physical cycle, the first
day of menstrual bleeding is designated as "day 1" of the menstrual cycle in
The time of the cycle during which menstruation occurs is referred to as
menses. The menses occurs at approximately four week intervals, representing the
Menarche is the time in
a girl's life when menstruation first begins. Menopause is the time in a woman's life when the function of the ovaries ceases
and menstrual periods stop.
The average age of menopause is 51 years old.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 7/20/2012
Menopause Symptoms: Emotional, Physical, and Sexual
Some of the symptoms of menopause can actually begin years before menstrual periods stop occurring. Doctors generally use the term "perimenopause" to refer to the time period beginning prior to the menopause (when some of the signs and symptoms of menopause begin to occur) up through the first year following menopause. Menopause itself is defined as having had 12 consecutive months without a menstrual period.
Menopause symptoms begin gradually while the ovaries are still functioning and a woman is still having menstrual periods. These symptoms can begin as early as the 4th decade of life (when a woman is in her 30s) and may persist for years until menopause has occurred. The symptoms occur early because the levels of hormones produced by the ovaries (estrogen and progesterone) decline slowly over time, explaining why pregnancy is still possible, but less likely to occur, as a woman reaches her forties. The severity and duration of symptoms vary widely among individuals - some women may experience only minimal symptoms for a year or two, while others may experience at least some of the symptoms for several years.