A:
Many different conditions can cause heavy periods. See your doctor for a full evaluation to find out the cause of your case.
The best treatment will depend on the cause of your bleeding. You may need to be treated for your anemia and the condition that is causing the bleeding.
Doctors go through a process to find the cause of abnormal bleeding. They look at a list of possible conditions that cause a symptom. Then they organize the list so the most likely causes are considered first. As conditions are "ruled out," the list becomes more focused until your diagnosis is made.
The first step in paring down the list is to take the patient's health history. Important factors used to identify the most likely cause of heavy vaginal bleeding are the:
- Age of the patient
- Pattern of bleeding
- Time over which the bleeding has developed
- Use of medications (especially those containing hormones
- Presence of other medical disorders
- Patient's sexual activity
A physical exam is then needed to narrow the source of bleeding. The uterus is the most likely source, but it is important to consider the possibility that the blood is coming from another organ in the genital tract, such as the vagina or cervix. In some cases, the bowel or bladder might be the cause of mistaken vaginal bleeding.
To give you a sense of how extensive the causes of heavy bleeding can be, here is a partial list of possible diagnoses for a 38-year-old woman:
- Pregnancy
- Failure to ovulate (anovulation)
- Cervical or uterine polyps (benign growths)
- Fibroids
- Infection
- Blood clotting disorders
- Thyroid conditions
- Medication side effects
- Precancerous conditions and cancer
The list would be different for a woman in menopause or a teenager.
Treatment must be tailored not only for the condition but also for the patient's goals. For example bleeding from fibroids might be treated using medicines, but fibroids can also be treated surgically. In some woman, a hysterectomy might be the best treatment. However, in a woman hoping to have a family, this would be recommended only as a last resort to manage serious bleeding that did not respond to less invasive treatments.
Even though the list of possible causes is long and treatment options vary widely, heavy bleeding is a common condition that can be successfully treated. Your doctor will help find the best treatment for you.
