Abnormal Periods: When Should You Worry?

" Welcome to our -- Kathy I'm Mary lack there. Abnormal uterine bleeding -- an often debilitating condition that affects hundreds of thousands of American women. But what exactly Internet. Well today we have more of the nation's leading got a column to help prevent a backlash and let me introduce them to you doctor Linda Bradley. Director history optic service at the Cleveland clinic. -- even Colin. Director of the center of the wind minimal access surgery at Columbia University. -- to keep Isaacson. Director of reproductive endocrinology and infertility and Massachusetts General Hospital. And Harvard medical school and doctor -- associate clinical professor at the medical college of the continent and director of reproductive endocrinology at Saint Mary's hospital in Milwaukee Wisconsin. Abnormal uterine bleeding exactly what is it."

" And that's good question. Because there's many definitions of abnormally you know and pleading. Basically. We need to -- upon what normally hear from cleaning and normally uterine bleeding is in menstrual cycle. Occurs. Maybe three to five days where you believe. Comes every three to five weeks and a reasonable amount of -- maybe three tables don't. So abnormal bleeding then becomes. Anything that differs from normal sort of period bleeding in the middle of the month -- you bleeding all month and just -- if you appeared to much heavier. And should be on average. Those things that and under the -- and an abnormal uterine bleeding."

" Also bleeding that would interfere with your life -- help. Athletic activity. Sexual activities. -- Work. I'm not going to have a -- cycles are able to work and not just activities because of bleeding because it's being embarrassed. I'm because of oil and through clothing on being humiliated because of academic. I'm most women on the average or use without appearing in Tampa on what -- tampons baby or five times a day. I'm made -- more often hygienic reasons but not because her soiling your debt ratings group. Are you still had used her father number had per day or anything about the beyond that I'm I think you should come -- your doctor."

" You saw -- understand that it's a woman president Menem pot. And and no period for a year. And he's not on any hormone replacement therapy than any bleeding whatsoever. That vaginal. Is that normal. And he's being evaluated because and that patient population. He didn't need to rule out -- because he is and her -- until."

" For the patient to keep track when there's tackle this lady is happening and help them document that. Information and when they go to their doctor many of the diagnose can be narrowed down by bleeding calendar. -- I didn't Maureen Kraft and tiny. Men are on how long if you are hormone replacement therapy when completing be happening on that replacements. Although things are clues to help figure out what is the core of the problem. Look at the causes -- and one big category it caught -- homeowner at humility and that's a very infrequently. Campus and who called her to career and his knees I think then it's not popular and a regular -- only good news a little bit to a male hormones are -- grow a little bit of obesity. That's a quote one of the upon normal categories. And that -- an -- grouping where you can have power. Which is an outfielder but should that and the natural lining. Up prior RA which is smooth muscle tumors that X agents in the cavity or -- the uterus. Or can they can't -- it can't conditional said that the main groupings that are negotiating with abnormal bleeding."

" It -- her most of -- and I'm we have subtle things that kind we want to enter different had you know leads a psychiatrist how to wouldn't you minutes you don't stop bleeding or electric position now. He had a topical out of teenager perhaps I'm an actor had a baby hammered a lot. Let me forget about these bleeding problems in the -- know are very very subtle clues that can lead a doctor -- won't rent out. These are very expert attack and certainly not every woman need to -- that a woman -- it's easy. -- Crushing your teeth come league very easily. On paper cut a town not -- looking signal and our history taking -- you know maybe. -- you know 300 dollar test would be helpful but I don't want women to think that they are -- woman needs that particular asked a testament to notice -- changes Tomlinson looked -- plus a lot of women using herbal product now -- and while I'm -- dollar -- and I think some other current -- are associated with problems that lead to bleeding. Top black women -- you -- aren't. On an accurate take anything over the counter. You wallet or does that not because these other things can lead to -- not always argued -- important thing you can't the force for that reason we get so focused on just computer that there could be other things systemically that cause problems."

" The thinking isn't most of this can be. Determined Franklin street dwindles when -- first if they and so they have. Irregular cycle and it's unlikely that they have a hormone problem. And therefore irregular cycle these are very good. Candidate that patients could be offered -- he has trust and not. It's irregular. As grace was talking about those of patients who do very well what -- model treatment. And those who had leaning problem typically apparently bleeding problems as they are cattle on. And I will be picked up on the screen so a simple this treat -- questions. Usually can put these until wanted to -- category."

" Are there other tests involved. Such as ultra sound -- I think we want to be I'm. Brought -- about our work opt opt in terms of what technology we -- I look at the use of ultrasound -- another procedure that added to that are included usually anarchy. That -- has dropped me on what doctors -- now I'm doing it I'm like -- can turn -- the patient has a normal -- just Iraq could -- I'm certainly. Allow full evaluation of the uterine lining itself wasn't very very large -- I'm Daryn they're maybe other procedures maybe I -- and that may be helpful. Can't remember that computer is only about sizable amount and -- women leave their positions oftentimes they. I'm they -- know whether they have a normal high bidder won the size of a Great Britain won the -- watermelon because the technology. And what we can offer our patients for treatment. Really depends on -- we don't want to think it. Surely one procedure or not their position they need to use vote on our evaluation. Of what I thought we talk a little bit about treatment options are abnormal uterine bleeding."

" Again. Once you have to be accurate diagnosis and then make the treatment but -- The beauty to his -- opinions once you're seeing that there is Apollo and -- nearest point it has a librarian at a computer. You don't have to take out an entire uterus to treat it though that's still a reasonable option you can just -- that isolated outing. And take care Vietnam uterine bleeding."

" Don't want you to cover the concert ticket patient who has a call. What do you do -- Those two options -- pops one to remove them Laporte. And it requires an operative and -- a little bit bigger from the guys now a critic but a very well tolerated. In a matter of passing grasp it through. Our small listen in to -- the panel in the wall -- and remove that you can. Other options to do it -- not operating rooms I think. And there will be don't need -- IV sedation. George Allen and usually I addictions is adequate for this procedure. -- the patient has found -- barely. Good times I've sort."

" Clever answer is that in the uterine cavity. It's the most the time will be treated in the operating room. And this nation now has you -- options. For removing my purse again if we start with the most extreme. Candidate tricked me it'll remove the vibrant and it'll never comeback there's nothing wrong with that. But you can also be offered -- therapeutic distrust of being in which hey I'll larger scope this place through the cervix. Andy vibrant it's actually -- out using electrical current. Are very rarely using laser energy. Now these space -- also has some other options including Peter an artery mobilization. In which the blood vessels that -- actually. Looted the very tiny particles. And when you Koppel what's apply it to -- uterus it turns out the muscle theaters does not dying. In the -- well. So that is another pop pop and that's a better option for patients who had very large fibroid. They have symptoms of pressure on -- Blatter parlor pop that it can also worked --"

" All the complaining. It is the major problems between relatives mingling and we're really not treating what we're not here to treat fibrous. Tissue to throttle problem because honestly -- So don't need the best way to treat cleaning it is desperately to treat the bleeding. And onlookers America fibroid you're hiking or not an aura -- pretty. -- proportion of the fiber during the -- you don't want to gratuity to procedure called enemy drawn boy and where we actually. Just destroyed the to shoot that would generate every month -- in concert period and and that's want to stop me from -- I don't -- of the hybrid not act like he's set it into the other symptoms in the upper pressured urinary frequent any pain out of him and then the hybrid recruited. There comes a hybrid and just waiting. I just abnormal wearing that. Usually that approach with the problems are complaining about."

" His father often. Is -- the average is not the one that's very suitable for uterine artery implication because that can be passed through a survey of being -- And -- patient. Steve's saying you didn't -- terrorist act that her symptoms are just starting bleeding from the remaining hybrid and her other types of removal. IMac to me is how close ranks where. You remove the five brides that are in the -- the uterus and reconstruct uterine. What does the ability to get pregnant and preserve fertility."

" Both of her patience I'm with uterine fibroid. The important thing there. All of us realize that there aren't worth are rarely cancer. And unfortunately some doctors use the language learners or how to mask and these are very frightening -- how -- work let's -- In the way that we think within uterus itself rarely cancers. One out of a thousand women has stuck. Cancer -- are quite likely when your luck when it when you're looking at options. Hysterectomy should be a laptop aren't on. Well let alone because rarity at cantor and then we can attention and look at other. I don't think we can trade."

" I think however. There are advantages. And disadvantages to all the treatment options that we discuss. There is some advantages I think it's strictly for example that we know of fiber and never come back. The -- that extremists have banished children has got the protection and doctors know incision. It's outpatient in your back in normal like Al and wondered what reported hours. The point is that I think the patients should be given all options that are appropriate. That a patient and being well educated which is the responsibility. I don't think health care provider and then -- you adding liquid proper kind."

" I think that the -- how many women happens that hysterectomy is the only -- on a wet cat like that shouldn't be very informative to say. The pair got three or four other things that may be able to do that we'll give it to your life being attacked."

" That's a good partner and it's -- to -- where we're -- you don't bleeding and not having cancer -- to where there covering. Provider of possession left you only one pop and something not quite right."

" But the company still well on -- and well armed position happily you can bleeding can be a thing of the -- from an absorbent. And thanks very much an important discussion on -- uterine bleeding and thank you a -- and fat --"