Menstrual disorders are common in women during their reproductive years. Menstrual disorders can include very irregular periods, heavy periods, heavy and prolonged periods and very prolonged periods. In the majority of cases this is usually secondary to either a hormonal problem or can occasionally be secondary to some form of pelvic pathology such as endometrial polyps or fibroids. If you are worried about your bleeding pattern then some simple tests may explain what is happening and you may benefit from some very simple treatment.
An examination for menstrual disorders is important to exclude any cervical abnormalities and a pelvic ultrasound scan to look for pelvic pathology. If a fibroid is suspected in the cavity of the uterus or a polyp, it may sometimes be necessary to perform a Saline installation sonography to evaluated the uterine cavity. Endometrial polyps are commonly seen and can cause intramenstrual and post coital bleeding. If found they can be removed by means of a minor operative procedure called a hysteroscopy and polypectomy. The relationship between polyps and sub fertility is unclear but certainly any couple embarking on fertility treatment or considering achieving a pregnancy, should have polyps removed prior to doing so.
It is recommended that women over the age of 40 who develop menstrual disorders should be investigated by means of a hysteroscopy, to ensure that nothing is missed within the uterine cavity.
Fibroids are the most common benign tumours seen in women. Three types of fibroids exist depending upon their location. Fibroids that sit on the outer surface of the uterus are called subserosal fibroids and they do not cause problems unless they are very large, in which instance they can cause pressure symptoms either on the bladder or the rectum. They are not associated with fertility problems. They also do not cause abnormal uterine bleeding.
Intramural fibroids are fibroids contained within the main body of the uterus. There is an association between the presence of intramural fibroids and sub fertility that association depending upon the size and location of the fibroids within the uterus. Large intramural fibroids can also cause pressure symptoms on the bladder and rectum.