Vaginal Bleeding (cont.)
How is irregular vaginal bleeding treated?
Treatment for irregular vaginal bleeding depends on the underlying cause.
After the cause is determined, the doctor decides if treatment is actually
necessary. Sometimes, all that is needed is for dangerous causes to be ruled out
and to determine that the irregular vaginal bleeding does not bother the woman
enough to warrant medication or treatment. If thyroid, liver, kidney, or
blood clotting problems are discovered, treatment is directed toward these conditions.
Medications for treatment of irregular vaginal bleeding depend on the cause.
Examples are described below:
- If the cause of the bleeding is lack of ovulation (anovulation), doctors may
prescribe either progesterone to be taken at regular intervals, or an oral
contraceptive, which contains progesterone, to achieve a proper hormonal
balance. Such treatment dramatically decreases the risk of uterine cancer in
women who do not ovulate.
- If the cause of irregular vaginal bleeding is a precancerous change in the
lining of the uterus, progesterone medications may be prescribed to reduce the
buildup of precancerous uterine lining tissues
in an attempt to avoid surgery.
- When a woman has been without menses for less than six months and is bleeding
irregularly, the cause may be menopausal transition. During this transition, a
woman is sometimes offered an oral contraceptive to establish a more regular
bleeding pattern, to provide contraception until she completes menopause, and to
relieve hot flashes. A woman
who is found to be menopausal as the cause of her irregular bleeding may also
receive menopause counseling if she has troubling symptoms.
- If the cause of irregular vaginal bleeding is polyps or other
benign growths,
these are sometimes removed surgically to control bleeding because they cannot
be treated with medication.
- If the cause of bleeding is infection, antibiotics are necessary. Bleeding
during pregnancy requires urgent evaluation by an
obstetrician.
Endometriosis
can be treated with medications and/or surgery (such as
laparoscopy).
- Sometimes, the cause of excessive bleeding is not apparent after completion
of testing (dysfunctional uterine bleeding). In these cases, oral contraceptives
can improve cycle control and lessen bleeding.
- If bleeding is excessive and cannot be controlled by
medication, a surgical procedure called
dilation and curettage
(D&C)
may be necessary. In addition to
alleviating the excessive bleeding, the D&C provides additional information that
can rule out abnormalities of the lining of the uterus.
- Occasionally, a hysterectomy is necessary when hormonal medications cannot
control excessive bleeding. However, unless the cause is pre-cancerous or
cancerous, this surgery should only be an option after other solutions have been
tried.
Many new procedures are being developed to treat certain types of irregular
vaginal bleeding. For example, studies are underway to evaluate techniques that
selectively block the blood vessels involved in the bleeding. These newer
methods may be less complicated options for some patients and as they are
further evaluated they will likely become more widely available.
Next: Vaginal Bleeding At A Glance »
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