IRREGULAR BLEEDING - Fred Creutzmann, M.D. - Carrollton, TX              972-394-7277 or http://www.drcmd.com/

The menstrual cycle is a biological event. No matter how regular you have been in the past, an irregularity in the cycle can occur. The menses are controlled by hormones, usually the female hormones estrogen and progesterone, but other hormones can effect them as well.

Adrenaline and cortisol are hormones, and they are the body's response to stress. Stress can affect the female cycle. There was a study done with female recruits who were followed through their boot camp. This was a group of women who were taken from their homes and put into a very new job setting. They left their families and friends and were put into a new social structure. Their sleep schedule was changed. Their physical activity was increased and their diets changed. Any one of the above changes can be enough to alter a woman's cycle, and one third of these women had menstrual irregularity! If bleeding is stress related, it will generally resolve on its own after a couple of cycles. If it does not, there are several ways I can help restore your normal pattern. Call me if you are concerned.

Some reasons to be seen by a doctor for bleeding are: if you are bleeding so heavily you are in jeopardy of becoming anemic, if there is pain or fever associated with the bleeding, if you think you may be pregnant or if you are in your 40s. The 40s are when there is some decline in hormonal secretions by the ovaries, and a change in menstrual pattern can be expected. Unfortunately, this is also a time when uterine cancers start to appear and irregular bleeding may be the first sign. Your physician may advise observation or do a biopsy inside the uterus to check for an abnormality.

If the problem continues and it is resistant to medical treatment, a surgical procedure is a last resort. D&C stands for dilation and curettage. This means the cervix (the mouth of the womb) is dilated and then the lining of the womb is cleaned out with a currette (a kind of sharp spoon). This cleans out the uterus and allows a fresh start. The uterus can also be looked into with an instrument called a hysteroscope. This allows the physician to see where the bleeding is coming from in the womb. Using hysteroscopy and either electricity, a hot water balloon or a laser, the lining of the uterus can be burned away to stop the bleeding, this is called endometrial ablation. (WATCH NovaSure Ablation VIDEO) Bleeding can also be caused by an abnormality in the anatomy of the uterus such as fibroids. If the uterus is enlarged a hysterectomy may also be considered if the problem is persistent. Talk to me about continued bleeding problems and we can decide what to do.