CAUSES OF HEAVY BLEEDING IN WOMEN

 

 

Dr. Steven R. Goldstein MD is a leading Gynecologist in NYC and an internationally renowned expert in Gynecologic Ultrasounds. In private practice for over 25 years, Dr Goldstein sees many female patients with medical complaints related to heavy periods (menorrhagia), heavy periods or abnormal vaginal bleeding.

 There are several causes of heavy bleeding in women and each needs to be evaluated by a board-certified Gynecologist. At times the bleeding is accompanied by pelvic pain or cramping. Dr Goldstein, a gynecologist in NYC for heavy bleeding, lists out a few of the reasons for heavy vaginal bleeding in women.

 One of the causes of heavy bleeding is uterine Fibroids. Fibroids are also known to cause heavy bleeding at the proper time due to growth of the uterine cavity such that there is more surface area and heavy menstrual bleeding at the proper time. Small Fibroids can also cause bleeding depending on where they are located in the uterus. Even small fibroids that impinge on the endometrial cavity (lining) can cause significant bleeding.

 Adenomyosis (endometriosis of the uterus or myometrium) may result in heavy menstrual bleeding at certain times. Historically, heavy menstrual bleeding (menorrhagia) and painful menstruation (dysmenorrhea) are the major symptoms of adenomyosis. This condition is benign, but can be very painful. It is due to the inner lining of the uterus protruding through the muscle wall of the uterus.

 Women with many children will see growth of the size of their uterus, which increases the surface area of the uterine lining. In this case bleeding may be heavy without there being any abnormality.

 The presence of uterine polyps in synchrony with the normal menstrual cycle can result in heavy menstrual bleeding at the appropriate time.

 What can a woman do about heavy bleeding? Dr Goldstein, a Gynecologist in NYC      

recommends that women have a Transvaginal Ultrasound or Sonohysterogram as the first means of diagnosis rather than invasive surgeries like blind endometrial biopsies.

These procedures produce clear, high-resolution images of the uterus, uterine lining, the wall of the uterus, fallopian tubes, ovaries which are used to make an accurate diagnosis.

 Dr Steven R. Goldstein is a Professor of Obstetrics and Gynecology at New York University School of medicine, a former Director of Gynecologic Ultrasound at NYU Langone Medical Center and a Past President of the American Institute of Ultrasound in Medicine. Dr Goldstein performs all transvaginal ultrasounds and Sonohysterograms personally.

 

COULD IT BE ENDOMETRIOSIS?

 

 

Dr Steven R. Goldstein is a NYC Gyn and specialist for Endometriosis in NYC. Endometriosis is an all-too-common gynecologic condition where the glands that lie inside the uterine cavity can come to lie outside the uterus in the pelvis. When the endometrial glands bleed (that is a period) these glands located outside the uterus bleed as well. This can cause some scar tissue. If there is a collection of this blood within the ovary, it is referred to as an endometrioma (or sometimes called a “chocolate cyst”).

Endometriosis can also take the form of small deep implants of endometrial tissue in many different places in the body, including the wall of the bladder, the anterior abdominal wall, the bowel wall and the uterosacral ligaments, as well as other pelvic sites. Rarely endometriosis can occur in sites such as the lung, potentially causing hemoptysis.

What are the symptoms of Endometriosis?

The exact cause of endometriosis is unknown and there are multiple theories. Endometriosis does not always show symptoms. There appears to be a higher incidence of endometriosis in women who are diagnosed with infertility and pelvic pain. Symptoms of Endometriosis include pelvic pain, painful periods, heavy bleeding during periods, or bleeding between periods.

 

Painless Diagnosis of Endometriosis by NYC Gyn

Increasingly, transvaginal ultrasound can make a very strong presumptive diagnosis of endometriosis without any surgical laparoscopy which, until recently, was the gold standard for making a definitive diagnosis. An endometrioma of the ovary has a classic appearance and, when present, can confirm the absolute diagnosis of endometriosis.

However, there are times where there is no obvious endometrioma, but the presence of scar tissue can result in structures becoming adherent to each other and be a source of pain. Such abnormal mobility can be judged by transvaginal ultrasound but only if it is done dynamically. Unfortunately, this is not generally practiced here in the United States where a technician instead takes dozens of still two-dimensional images which are later read by the radiologist.

What is a dynamic Transvaginal Ultrasound for Endometriosis?

Dr. Goldstein, an Endometriosis Specialist NYC, as well as most European doctors, performs his own ultrasound, and movement of structures at the time of the exam can often give a strong clue to adhesions associated with endometriosis, as well as eliciting pain with the probe and the abdominal examining hand which can also be indicative of a high likelihood of endometriosis.

Dr. Goldstein, a leading NYC Gyn has helped to author a paper entitled, “An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis.”

What can you do about Endometriosis in NYC?

If you suffer from pelvic pain and think there is a suspicion of any endometriosis, a dynamic ultrasound performed by an expert sonologist like Dr. Goldstein can be extremely helpful in making the diagnosis without surgery, and then beginning medical intervention for treatment. Schedule an appointment with Dr. Steven R. Goldstein, a top NYC Gyn for an evaluation.

 

 

 

 

LOCATIONS FOR FIBROIDS IN THE UTERUS

 

 Doctor Steven R. Goldstein is a top NYC Gynecologist for Fibroids. Uterine Fibroids are common growths found in the uterus and are also called leiomyomas or myomas. They can vary in size and there can be more than one. It is important to note that uterine fibroids are not cancerous and will not become cancerous. Secondly, the size of the uterine fibroid does not determine whether it is painful or causes bleeding. There are women with very large fibroids who experience no pain. On the other hand, very small fibroids can cause a lot of pain and bleeding if they impinge on the uterine lining.

 

Uterine Fibroids are further described by their location in the uterus. An Intramural fibroid occur within the confines of the muscular wall of the uterus (the myometrium). These are the most common types of fibroids.

 

A submucosal fibroid is one that protrudes into the endometrial cavity. It can have a “stalk” (known as pedunculated in medical terms) and slides down into the cervix as the uterus tries to expel it.

 

A subserosal fibroid is one that indents the serosal surface and gives a bumpy appearance of the outside of the uterus. It can grow outward and remain tethered to the uterus by a pedicle. This is called a pedunculated fibroid. Degenerating fibroids in the uterus most commonly appear as a donut mass with a thick wall, cystic center. This can cause severe pain and is more common during pregnancy.

 

Dr Goldstein, a NYC Gynecologist for Fibroids , uses painless Transvaginal Ultrasounds to find the reason for any pain or abnormal bleeding. Using Transvaginal Ultrasounds (water sonograms), Dr Goldstein is able to see the uterus, uterine lining, fallopian tubes, ovaries, cervix and pelvic area. He personally performs all transvaginal ultrasounds in his office in a few minutes and can show the patient on the screen or the clear, high resolution images, especially if the Doppler color flow is used.

 

Dr Steven R. Goldstein, a top Gynecologist in NYC, is a Professor of Obstetrics and Gynecology at New York School of Medicine, served as a former Director of Gynecologic Ultrasound at New York University Medical Center and is a past President of the American Institute of Ultrasound in Medicine. He is considered one of the nation’s top doctors in Gynecology, and is an internationally recognized expert in gynaecological ultrasound and imaging.