Abnormal Periods

There are many reasons why your periods might change over time. They might be irregular because of changing hormone levels. Periods can also change because of certain gynecologic conditions. During the diagnosis process, your provider will run tests to check for possible reasons why your period isn’t acting the way it typically does. Some of the conditions we will test for include:

• Endometriosis.
• Pelvic inflammatory disease (PID).
• Polycystic ovary syndrome (PCOS).
• Uterine fibroids.
• Cervical cancer.

Your mind might race with worries when you think about what might be causing your abnormal periods. We’ll walk you through this process one step at a time. We start by talking with you about the changes you’re seeing and learning more about what your menstrual cycle typically looks like.

Our specialists do a physical exam, including a pelvic exam. We may recommend additional tests to diagnose abnormal menstruation, including:

• Blood tests: Healthcare providers take a blood sample to check for anemia and measure hormone levels.
• Endometrial biopsy: We take a small sample of tissue from your uterus during an endometrial biopsy. Specialists examine the tissue under a microscope to look for changes in cells that might be cancer and other abnormalities.
• Imaging tests: Our experts take a look at your pelvic anatomy using imaging tests. We may use a pelvic ultrasonography test (ultrasound) or hysteroscopy to see detail inside your cervix and uterus.
• Pap smear (Pap test): We take a sample of cervical cells during a Pap smear for examination under a microscope. Our experts look for abnormal cells that are cancerous or could become cancer.
• Vaginal culture: We take a sample of vaginal cells with a swab to examine for signs of infection.

Our specialists consider your typical menstrual cycle and what’s normal for you when developing treatment for abnormal periods. We may use:

Hormonal medications

Your provider may prescribe birth control pills that contain estrogen or progesterone to help manage heavy bleeding.

Pain relievers and pain relief strategies

If you have painful cramps, we may recommend over-the-counter pain relievers like acetaminophen (Tylenol^®) or ibuprofen (Advil^®). Your healthcare provider may also recommend sitting with a heating pad on your lower abdomen or taking a warm shower to relax your muscles.

Hysteroscopy

Experts use hysteroscopy to treat (as well as diagnose) abnormal menstrual bleeding caused by scar tissue (adhesions), fibroids and uterine polyps. During this procedure, specialists insert a thin instrument with a light and camera (hysteroscope) into your vagina to look at your uterus.

The specialist passes small surgical instruments through the hysteroscope to remove growths and scar tissue. Experts may also perform endometrial ablation therapy during hysteroscopy to help control heavy bleeding.

Minimally invasive gynecologic surgery

Cleveland Clinic gynecologic surgeons are experts in using laparoscopy, a minimally invasive surgical technique. Surgeons insert a thin instrument (laparoscope) through tiny incisions, which helps you heal faster than traditional open surgery. We use laparoscopy to:

• Remove uterine fibroids and scar tissue.
• Treat endometriosis.
• Perform a hysterectomy.

Fertility Preservation at Cleveland Clinic

If you’d like to have a child someday, abnormal periods may have you worried. We talk with you about your plans and recommend treatment options that focus on making it possible to become pregnant in the future.

Taking the Next Step

Abnormal periods can get in the way of your daily life. There are many reasons you might have unusual symptoms with your period. And when these start to keep you from the things that bring you happiness, it can be time to talk to your healthcare provider. At Cleveland Clinic, we can help craft a treatment plan that fits your goals and lifestyle.