As a top gynecologist in the Manhattan area, Dr. Pilshchik uses advanced diagnostics to help patients understand the causes of their abnormal bleeding to ensure they get the most effective treatment for optimal results.
A normal period lasts from four to seven days and occurs usually about every 28 days. Periods that occur outside that range – typically less than three weeks or more than five weeks apart – are usually considered abnormal. Bleeding that occurs between periods or after sexual intercourse, bleeding that's extremely heavy or light, or bleeding that lasts longer than a normal period is also considered to be abnormal.
Hormonal changes or abnormalities are the most common cause of most types of abnormal vaginal bleeding. Changes can occur as a result of menopause, puberty or medical conditions like endometriosis, thyroid disease or polycystic ovary syndrome (PCOS), or they can be caused by stress, significant weight changes, IUD use, changing your birth control pill, excessive exercise and even breastfeeding. Uterine fibroids, polyps and scarring (adhesions) can also cause abnormal vaginal bleeding.
Dr. Pilshchik will ask you questions about your health and lifestyle factors, and she'll also perform a pelvic exam to look for abnormalities and take a Pap smear. In some cases, colposcopy may be necessary to look at the vagina and cervix, or a hysteroscopy may be used to see inside the uterus. Hormonal changes may be confirmed with blood tests.
That depends on what's causing the abnormal bleeding. When hormonal changes are occurring and puberty and menopause are not to blame, hormone therapy may be ordered or you may be asked to change the birth control pill you're using. If fibroids, polyps or endometriosis are causing bleeding, you may need surgical treatment or other types of treatment to get bleeding under control. Other times, shifting your exercise routine or losing weight can help stabilize abnormal bleeding.