Abnormal Uterine Bleeding

What causes abnormal uterine bleeding?

In many women, a hormone imbalance causes bleeding. These women may have too much estrogen or not enough progesterone. Polyps or fibroids (small and large growths) in the uterus can also cause bleeding. Cancer of the uterus and infection of the cervix are other causes of bleeding. Sometimes a thyroid problem causes bleeding.

These are just a few of the problems that can cause abnormal uterine bleeding. These problems can occur at any age. But the likely cause of abnormal uterine bleeding depends on your age.

Women in their 20s and 30s

A common cause of abnormal bleeding in young women and teenagers is pregnancy. Many women have bleeding in the first few months of a normal pregnancy. Birth control pills or the Norplant birth control device can also cause abnormal bleeding. If an egg isn't released (ovulation) during your menstrual cycle, you might have abnormal bleeding--either light spotting between periods or heavy bleeding during your period.

Women in their 40s and early 50s

In the years before menopause, women have months when they don't ovulate. This can cause abnormal uterine bleeding. Thickening of the lining of the uterus (called the endometrium) is another cause of bleeding in women in their 40s. This thickening can be a warning of uterine cancer. In women in their 40s and early 50s, it's important to make sure uterine cancer isn't the cause of abnormal bleeding.

Women after menopause

Hormone replacement therapy is often a cause of uterine bleeding after menopause. Other causes include a thickened endometrium and uterine cancer. Uterine cancer is more common in older women than in younger women. But cancer is not always the cause of abnormal uterine bleeding. Many other problems can cause bleeding after menopause.

What tests can find the cause of abnormal uterine bleeding?

The tests your doctor orders may depend on your age. If you could be pregnant, your doctor may order a pregnancy test. If your bleeding is heavy, your doctor may want to check your blood count to make sure you don't have anemia (low iron) from the blood loss.

An ultrasound exam of your uterus shows both the uterus and the ovaries. It may also show the cause of your bleeding.

Your doctor may want to do an endometrial biopsy. This is a test of the uterine lining. It's done by putting a thin plastic tube (called a catheter) into your uterus. A tiny piece of the uterine lining is taken out and sent to a lab. The biopsy will show if you have cancer or a change in the cells. This test can be done in the doctor's office and causes only mild pain.

Another test is a hysteroscopy. A thin tube with a tiny camera in it is put into your uterus. The camera lets your doctor see the inside of your uterus. If anything abnormal shows up, your doctor can get a biopsy.

Will I need a D&C?

A D&C is a short name for dilatation and curettage. Whether you need it depends on your problem. When you have a D&C, the opening of your cervix is stretched just enough so a surgical tool can be put into your uterus. The tool is used to scrape away the lining of your uterus. The removed lining is checked in a lab for abnormal tissue. A D&C is done under anesthesia (while you're "asleep").

If you're having heavy bleeding, a D&C may be done both to find out the problem and to treat the bleeding. A D&C often makes heavy bleeding stop.

How is abnormal uterine bleeding treated?

The treatment depends on the cause. If the cause is a hormone imbalance, your doctor may suggest you take birth control pills or progesterone. If the bleeding is related to hormone replacement therapy, your doctor may change the amount of estrogen you take. If a thyroid problem is causing your bleeding, treatment of that problem itself may stop the bleeding. You may need surgery if you have endometrial hyperplasia or cancer.

 

Air Travel Health Tips

How can I improve plane travel?

Most people don't have any problems when they fly, but it's possible to make airplane travel safer and more comfortable. Here are some tips:

·         Carry enough of all of your medicines in your carry-on luggage. Ask your doctor if you should change your dosages if your eating and sleeping times will change at your destination. Bring enough medicine to last your whole trip. Take extra medicine with you in case your return trip is delayed.

·         If you have diabetes or epilepsy, carry a notification and identification card (like the "Diabetes Alert Card" from the American Diabetes Association [phone: 800-DIABETES, or write to the American Diabetes Association, 1660 Duke St., Alexandria, VA 22314]). Have the name and phone number of your doctor with you in case of an emergency. Remember to bring along the names and dosages of all of your medicines.

·         Since the air in airplanes is very dry, drink nonalcoholic, decaffeinated beverages and water so you don't get dehydrated.

What can I do about jet lag?

·         Get plenty of sleep before you leave.

·         Don't drink a lot of alcohol.

·         Eat well-balanced meals.

·         Avoid overeating.

·         Exercise as much as you can on your trip.

·         Use sleep medicines for only a few days.

·         Get used to a new time zone by going along with the local meal and bedtime schedules.

Melatonin may help with jet lag, but no one knows how long it can be used safely. Tell your doctor if you plan to take melatonin or any other herbal medicines.

What about pain in my ears?

If you usually have ear pain while flying, try taking a decongestant medicine before you get on the plane the next time you travel. You can also swallow often and chew gum during the flight. Babies can suck on a bottle or a pacifier during the flight. These tips work better if you try them before your ears start to hurt.

What else should I do?

Even healthy people can get blood clots in their legs after long flights. Try to walk every now and then during your flight (unless the crew tells you not to). It also helps to drink enough water, to stretch your calf muscles while you're sitting and to wear support stockings.

If your doctor wants you to take oxygen when you travel, remember to tell the airline about this way ahead of your flight. The airline will provide oxygen for you, for a fee. Federal air regulations don't allow you to carry your own oxygen unit on a plane. You'll have to make arrangements ahead of time for oxygen at your destination and also for layovers between flights. You can also arrange for special meals or a wheelchair ahead of time, if needed.

It's dangerous to fly right after scuba diving. You'll need to wait 12 to 24 hours after diving. Ask your doctor or diving authorities for guidelines on flying after scuba diving.