Abnormal Bleeding CAPT Mike Hughey, MC, USNR.

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Presentation transcript:

Abnormal Bleeding CAPT Mike Hughey, MC, USNR

Causes of Abnormal Bleeding 1. Pregnancy 2. Malignancy 3. Mechanical Problems 4. Hormonal Problems .

Rule out Pregnancy Patients of childbearing age with unexplained abnormal bleeding should have a pregnancy test

Rule out Malignancy Cervical cancer (Pap) Vaginal cancer (Exam) Ovarian cancer (Exam) Uterine cancer (Endometrial biopsy, but under age 40, cancer very rare) Invasive Cancer of the Cervix

Mechanical Problems Polyps Fibroids

Hormonal Problems Anovulation Ovulatory bleeding Delayed menses

Clinical Management: Evaluation 1. Pregnancy Test 2. CBC (anemia) 3. Recent negative Pap smear 4. Pelvic exam

Clinical Management: Treatment BCPs Bedrest

Clinical Management: MEDEVAC If BCPs/Bedrest fail to resolve the bleeding and it is heavy, MEDEVAC is the next step. Surgery (D&C, hysteroscopy, etc.) will be needed. This is best undertaken in other than operational settings.