This is part 2 in a 4 part series on the causes of heavy menstruation bleeding.  You can find Part 1 here.

Abnormal Growths

The uterus is an organ of the woman’s body designed to carry a developing baby.  It is the source of your monthly menstrual period when your not pregnant.  There are 2 main layers of the uterus.  The uterus is mostly made of a muscle tissue layer .  Not like the muscles of your arms and legs.  More like the muscle of your heart.  The second layer is the lining of the uterus.  This is called the endometrium (medical language).  The uterus muscle forms a sac.  The endometrium covers the inner surface of this sac

 

A major cause of bleeding comes from abnormal growth or a tumor in one of these tissue layers

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Polyps In The Uterus

Polyps are growths that occur in the lining of the uterus.  These growths form around a blood vessel and appear as finger-like projections from the normally flat endometrium.  Uterine polyps are extremely uncommon in women under 20.  They increase in frequency as women get older reaching their peak in the 50s.  Many times they can be silent, not causing any symptoms.  Other times they are a source of heavy, intermittent  or prolonged bleeding.  In the great majority of cases, these growths are not cancerous.  They are generally removed both to help with the symptoms but also to make sure that they are not cancerous.

 

This following video shows a nice view of a polyp taken from the perspective of an instrument called a hysteroscope which is placed into the sac or cavity of the uterus.

 

Endometrial Thickening

Another cause of heavy menstruation bleeding is endometrial thickening or endometrial hyperplasia (Medical Language).  This occurs when the lining of the uterus grows out of control.This is usually in response to an imbalance in the production of estrogen in the body over time.  This can be seen in women with irregular periods, Polycystic ovarian syndrome, and in overweight or obese women.

 

There are two types which can cause the same symptoms of heavy bleeding.  The first, simple thickening, is not associated with cancer of the uterus.  The second, thickening with abnormal cells (endometrial hyperplasia with atypia – medical language) can lead to uterine cancer.

 

Fibroids

Fibroids are a very common tumor of the muscle layer of the uterus.  They affect up to 25% of women during their child bearing years.  These growths are characterized by round ball like masses at varying depths in the muscular walls of the uterus.  Sometimes they can bulge into the sac/cavity of the uterus and push on the lining of the uterus.  Sometimes they bulge out of the outer surface of the muscular layer.  They are commonly associated with heavy and prolonged bleeding.  They may sometimes be associated with chronic lower abdominal discomfort, painful menstruation, painful sexual intercourse.

 

Diagnosis of an Abnormality of the Uterus

The diagnosis of these conditions can be made in your doctor’s office through the use of  ultrasound (sonogram).  Your doctor may need to do further testing such as Saline Infusion Sonography or instilling water into the sac of the uterus so that polyps may be seen.  Your Doctor may also do other testing such as a small biopsy of the lining of the uterus, or a hysteroscope to actually look inside the uterus for polyps or fibroids.