Abnormal Vaginal Bleeding

Menstruation occurs approximately every 21 to 35 days in reproductive-aged women. Abnormal uterine bleeding is any bleeding unrelated to normal menstruation. This may be any bleeding between periods or menstrual flow which is heavier than normal.

Abnormal Vaginal Bleeding

Some possible causes of abnormal uterine bleeding include:

  • Polyps (abnormal outgrowth of tissue)
  • Adenomyosis
  • Fibroids (benign tumors)
  • Cancer of the uterus, cervix, or vagina
  • Hormonal changes
  • Contraception pills or intrauterine device (IUD)
  • Infection
  • Problem with blood clotting
  • Trauma
  • Vascular malformation


Symptoms of abnormal uterine bleeding include bleeding between periods or after sex, spotting after menstruation, bleeding heavier or for more days than normal, and bleeding after menopause.


Your doctor will examine your personal and family health history as well as complete details of your menstrual cycles (dates, length, and type of bleeding). You will also have a physical examination and possibly blood tests to help determine the cause of your bleeding. Your doctor may also order a pregnancy test to rule out the possibility of pregnancy. A range of imaging tests such as ultrasound or MRI scans, which produce images of your internal organs, may also be ordered to diagnose irregular bleeding. A cervical smear and swab may be taken and sent for sampling to determine any abnormalities.


The type of treatment offered for abnormal bleeding is based on many factors, such as the cause of bleeding, age, and the desire for future fertility. Most cases of abnormal uterine bleeding can be treated with medications, except for a few cases which may require surgery.


Hormonal medications used to treat abnormal bleeding depend on whether or not you want to get pregnant, your medical history, and age. Hormones can be given as injections, vaginal creams or through intrauterine devices (birth control device which is inserted into the uterus). The hormones are slowly released into the body by these means and control the abnormal bleeding. Your doctor may also prescribe other medications, such as anti-inflammatory drugs or antibiotics to treat other causes of bleeding.

Surgical treatment

Your doctor may recommend surgical treatment, depending on your specific circumstances. Surgery may be performed to excise polyps or fibroids by a procedure called hysteroscopy, which uses a flexible tube or endoscope. Some other procedures like endometrial ablations (burning of a thin layer of the uterine wall to reduce bleeding) may also be recommended. Referral to an interventional radiologist for a procedure called uterine artery embolization (UAE) may even be suggested Hysterectomy (surgical removal of the uterus) may be considered if all other forms of treatments have failed or found to be unacceptable options. You can no longer conceive after hysterectomy.

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Angela Intili M.D.

Dr. Intili delivered both of my children and hopefully will deliver any future children! We have always felt heard, cared for and important in Dr. Intili’s care. She is thorough and personal in her care, remembering our concerns and needs whether in the office or on the labor & delivery floor at the hospital! She goes above & beyond for her patients and I am always happy to be in her care!


Frequently asked

What Insurance does your practice take?
Some insurance companies we accept: BlueCross Blue Shield PPO, BlueCross Blue Shield Presence EPO, BlueCross Blue Shield Presence St. Joe’s HMO, BlueCross Blue Shield Silver Cross HMO, Aetna PPO (Choice POS), Cigna PPO (Open Access), United Health Care PPO (Choice Plus) and Humana PPO (Open Access)
What office procedures do you perform in the office?
The following are performed at our office: Leep Procedure, Colposcopy Procedure, Cryosurgery  and  Endometrial  ablation  via  novasure ,  and  hysteroscopy
Is your practice able to do OB Ultrasound at the office?
We  perform  obstetrical  ultrasounds  and  gynecological
Which hospital(s) are you affiliated with?
Silver  Cross  Hospital  and  Adventist  St  Joseph  Hospital
Which hospitals do Dr Angela Intili deliver at?

Silver  Cross  Hospital  and  Adventist  St  Joseph  Hospital

Is Dr Angela Intil a Sole Practitioner?

Yes  ,  I have  been  solo practitioner  since  1994

Do you perform Gynecological Ultrasounds?


How often do I need a pap smear?
New guidelines  are 3-5  years,  however  a  pelvic  exam  may  be  needed  every year
At what age do I need a pap smear?
21  years  old
What age is menopause?
A median  age  of  menopause  is  54 years  old.  Perimenopause  may  begin 5-7 years earlier  ,  presents  with  irregular menses,  hot  flashes,  irritability    due  to  the  lack  of  progesterone ,  at  times  progesterone  supplement  may  improve  some of  these  symptoms
Are there conservative measures for hot flashes?

At  times  over  the  counter  supplement  may help,  however  some  contains  soy  which  should  be  avoided  in  women with  hormonal  related  cancers

How safe is hormonal replacement therapy?
There are  clear  benefits  to  hormonal  replacement  therapy ,  decreasing  the  risk of  cardiac  heart  disease,  osteoporosis,  and cognition. These  benefits are  present  within  the first  5  years of menopause.