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Abnormal Uterine Bleeding

 

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Ultrasound is a valuable tool in the diagnosis of abnormal uterine bleeding.  Some causes of uterine bleeding that can be evaluated by ultrasound include:

Fibroids.

Uterine fibroids are growths, or tumors, that develop in the muscular wall of the uterus. They may also be called myomas or leiomyomas, or simply fibroids. Fibroids are generally benign—that is, they are not cancerous. A woman may have just one fibroid, or many.

Fibroids are the most common kind of growths of the uterus. In fact, it is believed that approximately 20 to 30% of women have fibroids.

Size and location of fibroids

Uterine fibroids can range in size, for example from as small as a grape (less than 1 inch) to larger than a melon. They can appear:

  • Beneath the outer surface of the uterus

  • Totally within the wall of the uterus

  • Inside the uterus

What causes fibroids?

Not much is known about the cause of fibroids, but evidence suggests that their growth is related to estrogen and possibly other hormones. In fact, increased levels of these hormones may speed up the growth rate of fibroids.

Changes in estrogen and fibroid growth

Estrogen levels in the body may go up or down for a number of reasons. For example, estrogen levels rise and fall during the menstrual cycle. If you are pregnant or taking certain kinds of birth control pills, your estrogen level increases. When you enter menopause, your level decreases as your body stops producing estrogen. As a result, fibroids tend to be less of a problem at this stage of a woman's life.

Risk factors for developing fibroids

Even though the medical community is not completely certain what causes fibroids and why some women have them and others don’t, there do seem to be factors that may play a role.

Age

Middle-aged women are commonly diagnosed with fibroids

Weight

Overweight women are at a higher risk for fibroids

Race

African-American women tend to have the highest frequency of fibroids, although fibroids have been found in women of all ethnic backgrounds

 A Subsurosal Fibroid

 An Intramural Fibroid

Endometrial polyps

Endometrial polyps can also cause abnormal uterine bleeding.  These can be evaluated by hysterosonograpy.  A small catheter is inserted into the uterus through the cervix and fluid is injected with a vaginal ultrasound is being performed.  The fluid fills the uterine cavity allowing visualization of the polyp.

 An endometrial polyp outlined by fluid during a hysterosonogram
    
       

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