Abnormal Periods: When Should... Video Transcript

Participants

Linda Bradley MD, Steve Cohen MD, Keith Isaacson MD, Grace Janik MD

Summary

Does your period seem unusual? Is it surprisingly heavy, or unpredictable and infrequent? Abnormal uterine bleeding comes in many forms, and has many different causes, from fibroids and polyps to hormonal problems. Fortunately, in many cases the condition can be cured quickly and easily. Join our experts to learn why AUB happens, and what you can do about it.

Webcast Transcript

MARY WAGNER: Welcome to our webcast. I'm Mary Wagner. Abnormal uterine bleeding is an often debilitating condition that affects hundreds of thousands of American women. So what exactly is it?

Well, today, we have four of the nations leading gynecologists to help us answer that question. Let me introduce them to you.

Dr. Linda Bradley, Director of Hysteroscopic Services at the Cleveland Clinic; Dr. Steven Cohen, Director for the Center of the Women's Minimal Access Surgery at Columbia University; Dr. Keith Isaacson, Director of Reproductive Endocrinology and Infertility at Massachusetts General Hospital and Harvard Medical School, and Dr. Grace Janik, Associate Clinical Professor at the Medical College of Wisconsin and Director of Reproductive Endocrinology at St. Mary's Hospital in Milwaukee, Wisconsin.

Abnormal uterine bleeding, exactly what is it?

STEVE COHEN, MD: That's a good question because there are many definitions of abnormal uterine bleeding. Basically we need to first define what normal uterine bleeding is. And normal uterine bleeding is a menstrual cycle which occurs maybe for three to five days where you bleed, comes every three to five weeks and has a reasonable amount of flow -- maybe three tablespoons. So abnormal bleeding then becomes anything that differs from normal.

So if your periods -- you're bleeding in the middle of the month. If you're bleeding all month and just spotting. If your periods are much heavier than they should be on average, those are things that fit under the definition of abnormal uterine bleeding.

LINDA BRADLEY, MD: There is also bleeding that would interfere with your lifestyle -- athletic activities, sexual activities, sports, work. Most women who have their menstrual cycles are able to work and not miss activities because of bleeding -- because of being embarrassed, because of soiling through clothing, being humiliated because of accidents. Most women on the average will use about -- if their using tampons -- will change a tampon maybe four or five times a day. Some may change it more often for hygienic reasons, but not because they're soiling or saturating through. If you're a pad user, the same number of pads per day. So anything up and beyond that, I think you should come and see your doctor.

KEITH ISAACSON, MD: You should also understand that if a women is in menopause and she's had no period for a year and she's not on any hormone replacement therapy, then any bleeding whatsoever that's vaginal is abnormal and needs to be evaluated. Because in that patient population, you do need to rule out serious disease such as cancer.

GRACE JANIK, MD: It's also helpful for the patient to keep track of when in their cycle this bleeding is happening and have some documented information when they go to their doctor. Many of the diagnoses can be narrowed down by a bleeding calendar -- whether it's ovulatory, preovulatory, menstrual and how long.

If you are on hormone replacement therapy, when the bleeding may be happening on that replacement. All those things are clues to help figure out what is the core of the problem.

MARY WAGNER: What could be some of the causes of abnormal uterine bleeding?

GRACE JANIK, MD: One big category of cards can be hormonal abnormalities. Patients who have cycles very infrequently and have a syndrome called polycystic ovarian disease causing them to not ovulate on a regular basis, and maybe produce a little bit too much male hormone. So excess hair growth, a little bit of obesity. So that's one of the hormonal categories.