The menstrual disorders can be classified as follows:

Functional ovarian cysts

Polycystic Ovarian Syndrome (newly renamed polyendocrine metabolic ovarian syndrome (PMOS) to emphasize that this condition involves multiple endocrine systems and metabolic issues)

Dysmenorrhea (Painful periods)

Endometriosis (Menstrual lining growing outside of the uterus causing pain, abnormal bleeding, possibly infertility)

Adenomyosis (Menstrual lining growing into the uterine muscle)

Heavy Menstrual bleeding (Excessive blood loss with menstruation that interferes with a woman’s physical, social, emotional, and/or material quality of life)

Abnormal uterine bleeding:

 When looking into the root cause of AUB, a combination of medical history, bloodwork, imaging of the uterus and ovaries, and hysteroscopy (shining light on the uterine cavity) leads us to nuanced answers. There are both structural and nonstructural causes of abnormal uterine bleeding.

Structural Causes:

P – Polyps (glandular tissue forming a finger-like projection) inside the uterine cavity

A - Adenomyosis (menstrual glands growing into the uterine muscle or myometrium)

L – Leiomyoma (Fibroids- smooth muscle tumors originating from the uterine walls)

M – Malignancy (Uterine cancer or precancer)

Nonstructural Causes:

C – Coagulopathy (abnormal clotting of blood)

O – Ovulatory Disorders (abnormal bleeding due to lack of regular ovulation)

E – Endometrial disorders (subtle inflammation of the uterine lining)

I – Iatrogenic (bleeding caused by medical interventions such as blood thinners)

N – Not classified

Fibroids and uterine polyps are common, usually non-cancerous growths that can develop in or around the uterus. While some cause no symptoms, others can contribute to abnormal bleeding, pelvic discomfort, pressure or fertility concerns.

Fibroids are growths made from muscle and fibrous tissue. They may develop within the uterine wall, project into the uterine cavity or grow on the outside of the uterus. Uterine polyps are softer growths that develop from the lining of the uterus and can vary in size.

Symptoms may include:

• Heavy or prolonged menstrual bleeding
• Bleeding or spotting between periods
• Irregular periods
• Pelvic pain, pressure or a feeling of fullness
• Menstrual cramping
• Frequent urination or pressure on the bladder
• Pain during intercourse
• Difficulty becoming pregnant in some cases
• Fatigue or weakness related to blood loss

At Artemis Center, we assess fibroids and polyps to determine whether treatment is needed based on your symptoms, the size and location of the growths, and your individual needs. Management may include monitoring, medication or minimally invasive procedures to remove growths that are contributing to bleeding or other symptoms.

Pain management for IUD insertion means using appropriate options to reduce discomfort before, during and after placement. While some people experience only mild cramping, others may have more significant pain, so care should be tailored to the individual.

At Artemis Center, IUD insertion is performed by experienced gynecology providers with attention to comfort, clear communication and gentle technique. Depending on your needs, pain-management options may include medication taken before the procedure, local anesthetic or other measures to help make insertion more comfortable.

IUD care can also include assessment before placement, removal or replacement of an existing IUD, and evaluation of concerns such as pain, bleeding or difficulty locating IUD strings.