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Abnormal Vaginal Bleeding

The inside of the uterus has two layers. The thin inner layer is called the endometrium and the outer thick layer called the myometrium. During the menstrual cycle, the endometrium thickens every month in preparation for pregnancy. If the woman does not become pregnant, the endometrial lining is then shed during the menstrual period. After menopause, the lining stops growing and shedding.

Abnormal bleeding occurs when there is excessive regular menstrual bleeding (menorrhagia) or erratic menstrual bleeding that is not part of your period. Any bleeding in post-menopausal period is abnormal.

If you are experiencing abnormal vaginal bleeding you should consult your GP or consult a specialist such as Dr Farjo.

Dr Farjo will diagnose and offer solutions to help manage your abnormal vaginal bleeding problems, whether this relates to abnormal menstrual bleeding, inter-menstrual, post-coital or post-menopausal bleeding

Common Causes of Abnormal Vaginal Bleeding

There are several reasons why you may suffer from abnormal vaginal bleeding, these include:

  • Polyps
  • Fibroids
  • Infection in the uterus or vagina
  • Hormonal changes
  • Abnormal pap smears
  • Adenomyosis
  • Ovulatory dysfunction
  • Atrophic vaginitis in postmenopausal women
  • Less common but important to rule out in peri and post menopausal women is endometrial cancer.

As part of your consultation Dr Farjo may schedule a number of tests. It is quite normal to perform a range of tests to rule out or exclude uncommon but nevertheless important potential causes such as cancer.

Possible Treatment Options

Depending on the cause of the bleeding there are a range of treatment options including:

  • Anti-inflammatory drugs
  • Antiboitics
  • Hormone therapy
  • Anti-bleeding agents
  • Surgery: like hysteroscopy and endometrial biopsy, removal od the polp or intra-uterine fibroids, endometrial ablation or hysterectomy.

Dr Farjo will discuss your treatment options once she has examined you and received the results of any additional testing she has scheduled.

Also please Refer to Menstrual Disorder for further information


Uterine fibroids are benign, slow-growing tumours found in the uterus. Also known as myomas, fibromyomas or leiomyomas, they may be single or multiple numbers. The condition is estimated to affect between 30 and 70% of women of reproductive age, making it the most common tumours in the uterus. Not all women will have symptoms related to the fibroids.

It is extremely rare for a fibroid to become malignant or cancerous (this is called leiomyosarcoma).

Fibroids are usually found within the muscle wall of the uterus. They can also be located on the outside surface the uterus, beneath the endometrium or in the cervical wall. The symptoms will depend on the location, size and numbers of the fibroids. The symptoms tend to get better after menopause.

Common symptoms are:

  • Increased menstrual bleeding
  • Pelvic pressure or pain
  • Problems with fertility and pregnancy

Diagnosis typically occurs through a routine pelvic examination, an ultrasound, or in some cases an MRI. The inside of the uterus can also be monitored via a hysteroscope, a thin tube attached to a small camera.


  • Conservative approach
  • Medical treatment like hormone birth control
  • Surgical options: Myomectomy, endometrial ablation or hysterectomy
  • Uterine artery embolization

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