A clear guide to abnormal uterine bleeding evaluation and treatment
September 9, 2026 • Season 4: Episode 35
Bleeding that feels “off” is easy to downplay until it derails your life or shows up after menopause. We revisit our conversation with women’s health nurse practitioner Kelsey Kennedy and layer in what’s changed since then, including newer ACOG guidance that supports a more proactive approach to postmenopausal bleeding. The key message is simple: a reassuring pelvic ultrasound alone is not always enough, because high grade endometrial cancer can occur even with a thin lining.
Kelsey and Dr. Thacker walk through what abnormal uterine bleeding actually means in real life, from irregular cycles and spotting between periods to heavy flow that soaks pads, clothes, and sheets. Then they sort the most common causes including fibroids, endometrial polyps, adenomyosis, and endometriosis, and we explain why minimally invasive gynecologic surgery (MIGS) teams can be so valuable when surgery is on the table or when prior care has not found the answer. They also highlight an often missed angle: some abnormal bleeding is driven by bleeding disorders like von Willebrand disease, not just gynecologic anatomy or hormones.
