Abnormal vaginal bleeding is caused by benign abnormalities of the uterus or cervix including fibroids, polyps, adenomyosis, and infection. Occasionally, malignant and premalignant conditions such as endometrial hyperplasia, endometrial carcinoma, and cervical carcinoma can be the cause. Innovative techniques like DualPortGYN developed by CIGC surgeons Paul MacKoul MD and Natalya Danilyants MD make it possible to safely treat complex GYN conditions, using only 2 tiny incisions.

1. T H E C E N T E R F O R
I N N O V A T I V E G Y N C A R E
What is Abnormal GYN Bleeding?
Recognize the Signs and Get Diagnosed

2. Abnormal Vaginal Bleeding: Signs
Abnormal vaginal bleeding is caused by benign abnormalities of the uterus or
cervix including fibroids, polyps, adenomyosis, and infection. Occasionally,
malignant and premalignant conditions such as endometrial hyperplasia,
endometrial carcinoma, and cervical carcinoma can be the cause.
Signs of Abnormal Bleeding:
 Less than 21 days between menstrual cycles
 More than 35 days between menstrual cycles
 More than 80 cc of blood loss with menstrual cycle
 Menstrual flows greater than 7 days
 Bleeding between periods
 Vaginal bleeding after menopause
 Bleeding after intercourse
 Only having 4 to 9 periods in a year

3. Abnormal Vaginal Bleeding: Treatment
For medical treatment, hormonal irregularities may be treated with birth
control that contains estrogen and progesterone. Non-steroidal Anti-
Inflammatory Agents (NSAIDs) such as Ibuprofen and Naproxen are given for the
duration of menstrual bleeding to decrease blood loss.
Surgical treatment can include:
 Hysterectomy
This procedure removes the uterus and the cervix, this will immediately stop monthly
cycles and eliminate abnormal bleeding. Hysterectomy can be used to treat fibroids,
endometriosis, adenomyosis, and uterine cancers.
 Dilation and curettage (D&C)
This is the fastest way to stop acute blood loss from the uterus. Patients with severe
bleeding and not responsive to medical therapy should have the procedure done to
stop the bleeding.
 Hysteroscopy
Hysteroscopy at the time of D&C may help identify
an organic cause of bleeding, such as a uterine
polyp or fibroid, which can be removed during the
same procedure.

4. CIGC’s Advanced GYN Techniques
Fellowship trained GYN surgeons of CIGC have performed over 20,000 GYN
procedures and are constantly finding better ways to improve outcomes for patients.
Innovative techniques like DualPortGYN make it possible to safely treat complex GYN
conditions in outpatient settings, using only 2 tiny incisions.

5. Minimally Invasive GYN Surgeon
Dr. Paul MacKoul, MD of CIGC:
About Dr. Paul MacKoul, MD
Dr. Paul MacKoul Reviews
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Get To Know Us
 Learn about our innovative GYN procedures:
DualPortGYN | LAAM and the CIGC Travel Program
Minimally Invasive GYN Surgeon
Dr. Natalya Danilyants, MD of CIGC:
About Dr. Natalya Danilyants, MD
Dr. Natalya Danilyants Reviews
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