What Conditions Should Be Considered If Heavy Menstrual Bleeding Persists?

Uterine Causes

• Uterine Fibroids: These benign tumors can cause heavy bleeding due to their size and location within the uterus.
• Endometrial Polyps: These growths on the inner lining of the uterus can lead to abnormal bleeding.
• Adenomyosis: This condition occurs when the endometrial tissue grows into the muscular wall of the uterus, often resulting in heavy and painful periods.
• Endometrial Hyperplasia: Thickening of the uterine lining can lead to heavy bleeding and may be a precursor to endometrial cancer.

Hormonal Imbalances

• Polycystic Ovary Syndrome (PCOS): This condition can cause irregular menstrual cycles and heavy bleeding due to hormonal imbalances.
• Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual patterns and lead to heavy bleeding.

Coagulation Disorders

• Von Willebrand Disease: This genetic disorder affects blood clotting and can lead to heavy menstrual bleeding.
• Other Bleeding Disorders: Conditions such as platelet function disorders or clotting factor deficiencies can also result in abnormal bleeding.

Infections

• Pelvic Inflammatory Disease (PID): Infections of the reproductive organs can cause abnormal bleeding and should be considered, especially if accompanied by pain or fever.

Malignancies

• Endometrial Cancer: Persistent heavy bleeding, especially in women over 40 or those with risk factors, should raise suspicion for endometrial cancer.
• Cervical Cancer: Abnormal bleeding can also be a symptom of cervical cancer, particularly if there are other concerning signs.

When to Seek Medical Attention

If heavy menstrual bleeding persists, it is crucial to consult a healthcare provider, especially if:

• The bleeding is soaking through one or more pads or tampons every hour for several hours.
• There are accompanying symptoms such as severe pain, dizziness, or fatigue.
• There are changes in menstrual patterns or bleeding between periods.

What to Expect at the Appointment

During your visit, the healthcare provider will likely:

• Take a Detailed Medical History: Discuss your menstrual cycle, any associated symptoms, and medical history.
• Perform a Physical Examination: This may include a pelvic exam to assess for any abnormalities.
• Order Diagnostic Tests: Blood tests, ultrasound, or endometrial biopsy may be necessary to determine the underlying cause of heavy bleeding.