Abnormal Vaginal Bleeding: Avoid the Rush to Hysterectomy

Many women do not look forward to their menstrual period each month. While completely normal, vaginal bleeding and the discomfort that it can come with—cramps, bloating, headaches, and more—can be rough to say the least. But at least it is expected. It’s when there is abnormal vaginal bleeding between menstrual cycles, and associated inconsistencies in the way your body typically operates, that can be concerning.

For instance, perhaps bleeding lasts longer than usual, shows up earlier than expected, or seems heavier than anything you have experienced before. Some women notice spotting between periods, while others find themselves changing feminine products like tampons and pads far more often than normal. When something like this happens, it is easy to assume the worst. Abnormal bleeding can be alarming, frustrating, and disruptive to everyday life.

That concern may lead women to seek answers—which is exactly the right instinct. However, after describing symptoms and undergoing initial testing, some women are surprised to learn they have uterine fibroids, and the recommended solution is to have a hysterectomy. But is fibroid surgery really the best solution? For some women, yes. But for millions more, it is one of many options to consider—especially when less invasive treatments may successfully address the underlying cause of abnormal vaginal bleeding.

Remember that knowledge is key, you are not alone, you do have options, and second opinions are always available.

What Is Considered Normal vs. Abnormal Vaginal Bleeding

Since every woman’s menstrual cycle is unique, it can be challenging to define what is normal vs. abnormal. But generally speaking, a normal menstrual flow typically lasts five to seven days and occurs every 21 to 35 days. The menstrual cycle is counted from the first day of one period to the first day of the next. Therefore, abnormal vaginal bleeding is bleeding from the uterus that does not occur at your regular time or is heavier or longer than what you are used to seeing. To put flow into perspective, each soaked normal-sized tampon or pad holds a teaspoon (5 ml) of blood, so a flow of more than 80 ml per menstrual cycle is considered menorrhagia or heavy bleeding.

Abnormal vaginal bleeding is typically characterized by:

• Heavier than normal bleeding or clotting
• Inconsistent menstrual cycles
• Bleeding between periods and/or after sex
• Periods that last longer than seven days

Abnormal vaginal bleeding may stop on its own, as there are many reasons for it that may or may not be a cause for concern. For instance, early pregnancy can result in surprise spotting between periods. Hormonal changes and birth control (pills, patches, injections, rings, etc.) can also be a cause. Abnormal bleeding is also commonly triggered by hormone imbalances in teenagers or in women who are approaching menopause. 

In each case, your doctor may offer less invasive solutions and suggest waiting to see if the problem gets better. On the other hand, abnormal vaginal bleeding can be a sign of more serious complications.

Abnormal Vaginal Bleeding Could Be a Sign of Something Else

If not checked out, abnormal vaginal bleeding can cause anemia and make you very weak and tired. More serious causes of vaginal bleeding can include, but are not limited to, the following conditions:

• Fibroids — Researchers estimate that 70-80% of all women develop fibroids between 35 and 54. These non-cancerous tumors develop from muscle tissue in the uterus and tend not to stay the same size. They can also multiply. Some women with fibroids may not experience any pain. Sometimes, doctors will discover fibroids during a routine pelvic or pregnancy exam and then refer their patients to a specialist to have the fibroids treated. But those women who do experience pain often say that what was at first minor symptoms or no symptoms eventually became increasingly painful as their fibroids grew and either became twisted or began to press against organs. A telltale symptom associated with fibroids just so happens to be heavy menstrual bleeding and longer periods.
• Polyps — These are abnormal tissue growths located on the inner lining of the endometrium or in the lining of the cervix. They are typically caused by an overgrowth of endometrial tissue and look like soft, red, ball-shaped growths attached to a stalk protruding from the uterine lining. They are non-cancerous, but that does not mean they can’t become a problem if left undetected or untreated. Sometimes, polyps will go away on their own and will not cause any pain. Other times, they can cause cramps, bleeding or spotting, and irregular menstrual bleeding. It should be noted that fibroids and polyps can appear similar on imaging tests, and a woman may have one or several of varying sizes and locations. They can also coexist in 20.1% of patients, according to one study.
• Infection — Many times, women can develop an infection in the cervix or lining of the uterus.
• Sexually transmitted diseases — STDs such as chlamydia may not lead to any noticeable symptoms. But in some women, abnormal vaginal bleeding and even painful periods can be a sign.
• Uterine and cervical cancer — In extreme cases, abnormal vaginal bleeding can be a sign of uterine and cervical cancers. Stay up to date with regular gynecological exams and have open conversations with your doctor. This can help catch vaginal bleeding before it becomes a major problem and leads to cancer.

Can I Avoid Hysterectomy to Remove Fibroids? What Are My Options?

A hysterectomy is a surgical procedure that many doctors turn to with female patients who suffer from fibroids and other uterine symptoms such as abnormal vaginal bleeding. Historically, hysterectomies have been extremely popular. In fact, roughly 600,000 hysterectomy procedures are performed annually in the United States. And the goal is simple: remove all or part of a woman’s uterus. In some cases, her fallopian tubes and ovaries are removed, too. When this happens, fibroids are also removed, and new ones have nowhere to grow.

With all of that said, many women say their bodies are never the same again. Hysterectomy can lead to additional hormonal changes, alterations in sexual feelings and sensations, and a higher risk for heart disease. In some studies, statistics show that women who underwent a hysterectomy could have chosen a less-invasive option.

That’s the good news: there are options. Let’s explore a few below:

More Options To Remove Fibroids and End Abnormal Vaginal Bleeding

• Medications — For less severe fibroids and vaginal bleeding, your doctor can discuss medications such as hormonal treatments to shrink fibroids or reduce heavy menstrual bleeding. For example, gonadotropin-releasing hormone (GnRH) agonists can temporarily shrink fibroids by lowering estrogen levels, providing relief from symptoms while patients decide on their long-term treatment options. Additionally, non-hormonal medications like tranexamic acid or NSAIDs can help control bleeding and pain without surgery.
• Watchful waiting — This approach involves regular monitoring of the fibroids without active intervention but still includes ongoing conversations with your primary care provider. Since fibroids often shrink after menopause due to the decrease in hormone levels, many women with asymptomatic fibroids may never need treatment. As a result, avoiding unnecessary procedures is something to be thankful for. This is particularly true for those who want to minimize medical interventions. That said, if you have ongoing abnormal vaginal bleeding, this may not be the best option.
• Uterine Fibroid Embolization — Rather than removing fibroids with surgical incisions, UFE cuts off blood flow to all fibroids. UFE is low risk, requires no hospital stay, is faster than surgery, and is a reliable way to treat fibroids. During a UFE procedure, tiny particles are inserted through nonessential blood vessels and into the uterus, blocking blood flow to all fibroids from the inside. With blood flow having been cut off, fibroids shrink and die. Thus, the patient experiences a reduction in symptoms. UFE is a unique procedure in comparison to others because of its ability to treat all fibroids—regardless of location or size—and without requiring painful surgery and lengthy recovery time.
• Myomectomy — This is a surgical procedure similar to a hysterectomy. That said, a myomectomy preserves the uterus while removing the fibroids and maintaining a woman’s ability to get pregnant again in the future. The size and location of the fibroids determine how this surgery is performed.
• Acessa — In this procedure a small probe is placed into a fibroid and heated. By heating the fibroid, it is ultimately destroyed. Acessa works even if you have several uterine fibroids. But there are limitations. For example, if you have multiple large fibroids (melon or grapefruit size) or fibroids that are hard to get to, Acessa is not a good choice.
• Endometrial Ablation — This procedure removes the uterine lining by placing a thin instrument into the uterus through the cervix and using heat, laser, electricity, microwaves, or freezing. The downside to endometrial ablation is that it is not safe to get pregnant afterwards. In addition, it is most effective with only small fibroids.
• Sonata System — This incision-less fibroid treatment works well when the patient has one or several fibroids. Using an intrauterine ultrasound device, radiofrequency energy is delivered to the fibroid to shrink the fibroid. As the fibroid shrinks, the patient can see a reduction in symptoms. As a relatively newer option, some patients in online forums have reported difficulty in finding a local Sonata provider.

At Fibroid Institute, we understand how frustrating and painful it can be to experience abnormal vaginal bleeding because of fibroids. And when you think your only option is a hysterectomy, the prognosis for the future can seem bleak. This is where we can help. If you are a candidate for UFE, our specialists can make being symptom-free as easy as 1-2-3.

Fibroid Institute Wants To Help You Overcome Abnormal Vaginal Bleeding

Many women who experience abnormal vaginal bleeding due to fibroids admit that they are often at their wits’ end. This is especially true as their symptoms take over their lives, interrupt their workdays, and keep them from doing what they enjoy doing and, most importantly, feeling like themselves.

At Fibroid Institute, we set the standard of care for advanced fibroid treatment to help women achieve a symptom-free life. We specialize in UFE because it delivers the best results in the least amount of time and with limited pain. On top of that, we simplify your UFE journey, managing everything from insurance to PCP communication and offering all patients physician-direct access before and after their procedure. With multiple locations, our fibroid clinics help thousands of women avoid fibroid surgery and find relief from their fibroid symptoms. Meet some of these women here:

Our fibroid doctors are board-certified interventional radiologists, highly experienced UFE specialists, and experts passionate about helping women become #FibroidFree. Request a free 10-15-minute phone screening to determine if you are eligible. If you qualify for UFE after the screening, you can schedule your on-site or telehealth consultation. Most major medical insurance providers cover the cost of UFE.

Get started now by calling our Dallas, Texas clinics at 214-838-6440, Houston, Texas clinics at 713-903-3733, South Carolina clinics at 843-628-4290 or complete the form below.

Before starting any new treatment or if you have questions regarding a medical condition, always seek the advice of your doctor or other qualified health provider. This information is not a substitute for professional medical advice.

The Fibroid Institute serves the Charleston, South Carolina, Dallas/Fort Worth, Texas and Greater Houston, Texas metro areas including Addison, Allen, Arlington, Bedford, Bellaire, Carrollton, Cedar Hill, Charleston, Clear Lake, Cockrell Hill, Conroe, Craig Ranch, Cypress, Dallas, DeSoto, Duncanville, Euless, Fort Worth, Frisco, Garland, Grand Prairie, Highland Park, Houston, Hurst, Hutchins, Irving, Katy, Kingwood, Lancaster, League City, McKinney, Mesquite, Mt. Pleasant, Murrells Inlet, Orangeburg, Park Cities, Plano, Richardson, Sherman, Spring, Stafford, Sugar Land, Summerville, Texas City, The Woodlands, Universal City, University Park, Walterboro, Webster and more.

*Patient names and/or photos may be changed to protect patient confidentiality.