If you are bleeding internally (hemorrhaging) or experiencing heavy bleeding along with pain or fever, seek help right away. Vaginal hemorrhaging is life-threatening and must be stopped in a medical setting. Heavy bleeding accompanied by severe pain or fever suggests an infection of the female reproductive organs called pelvic inflammatory disease, which can lead to infertility. Heavy bleeding could also be a sign of a miscarriage.
Occasionally, vaginal bleeding is heavy enough to require hospitalization. In this case, a high dose of estrogen is administered intravenously every 2 to 4 hours for 24 hours. If this fails, a D&C can control bleeding.
Your doctor is the best source of information on the drug treatment choices available to you.
Polyps and fibroids can be removed surgically. Single or small endometrial or cervical polyps can be removed with simple procedures that can be done in the doctor’s office under a local anesthetic. Larger or multiple growths may require more invasive surgery and hospitalization. If fibroids are particularly problematic, removal of the uterus (hysterectomy) might be advised.
Endometrial ablation is an option for women with recurrent abnormal bleeding who want to avoid hysterectomy and do not want to have children. This procedure involves using a laser or an electric tool to destroy all or part of the uterine lining, and results in the cessation of or infrequent periods. It is an outpatient procedure with a low complication rate, though there have been some reports of endometrial cancer developing later.
A total hysterectomy is the usual treatment for uterine cancer. This involves surgically removing the uterus, cervix, fallopian tubes, a portion of the upper vagina, and nearby lymph nodes. This is all that is done for early cancer. If the cancer has spread, radiation may be necessary.
A D&C may be necessary to control very heavy bleeding, and may also help the doctor to make a diagnosis.
Identifying and correcting an underlying problem almost always resolves abnormal uterine bleeding. When fibroids and polyps are removed, abnormal bleeding usually stops; likewise for a hormonal problem that is corrected. Long-term use of oral contraceptives can control bleeding that stems from anovulation, but does not address the source of the problem.
Uterine cancer caught early enough is highly treatable. The majority of women who develop uterine cancer survive and stay cancer-free for at least five years after diagnosis. Detected in the early stage, uterine cancer is highly treatable. The odds favor younger women, women whose cancer has not spread beyond the uterus, and women who have slow-growing cancers.
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