Treatment of uterine bleeding by obstetrician-gynecologist Irina Ivanovna Kulbach in the city of Dnipro

Patients often present with complaints of irregular or heavy bleeding, spotting outside of menstruation, pain, and discomfort in the lower abdomen.

The physician conducts a thorough clinical evaluation, reviews the medical history and symptoms, and, if necessary, orders additional tests to clarify the causes of the bleeding. The patient receives a clear and consistent action plan: what to do immediately, which examinations to undergo, and how to monitor changes in their condition over time.

Special attention is given to the differential diagnosis of the causes of bleeding, adjustment of therapy considering comorbid conditions, and continuous monitoring to ensure timely modification of treatment.

When to See a Doctor

Uterine bleeding can manifest in different ways, and it is important to promptly pay attention to changes in your condition. Sometimes bleeding occurs for the first time, other times it recurs or becomes more pronounced. Consulting an obstetrician-gynecologist will help identify the causes of these changes and choose the appropriate course of action. You should make an appointment with an obstetrician-gynecologist if you notice any of the following during uterine bleeding:

• Persistent or irregular spotting outside of menstruation
• Heavy bleeding that interferes with daily activities
• Increased bleeding during physical exertion or while taking medications
• Bleeding after sexual intercourse
• Pain or discomfort in the lower abdomen along with bleeding
• Symptoms occurring for the first time and causing concern
• Recurrent bleeding after previous treatment
• Bleeding that disrupts sleep or work
• No improvement from self-care measures aimed at reducing bleeding
• Symptoms gradually worsening or changing
• Bleeding during pregnancy or postpartum
• Need to clarify the situation in case of exacerbation or change in therapy

If you notice one or more of these symptoms, consulting a doctor will help determine the causes and develop an appropriate plan of action. Do not delay your visit if your condition worsens or symptoms recur — timely diagnosis is important for your health.

Emergencies or When You Should See a Doctor Immediately

• Sudden, heavy uterine bleeding that does not stop
• Increasing bleeding accompanied by dizziness, weakness, or loss of consciousness
• Severe lower abdominal pain combined with heavy bleeding
• Sudden onset of bleeding during pregnancy
• Bleeding accompanied by a high fever and a marked deterioration in general condition

If you experience any of these symptoms, do not wait for a scheduled appointment — urgent medical evaluation is necessary. Our clinic offers a home visit service, allowing you to receive help as quickly as possible.

Causes and Risk Factors of Uterine Bleeding

This section explains the main causes of uterine bleeding, as well as lists the factors that influence the risk of its occurrence and worsening. This will help to understand what is important to check when consulting a doctor.

Main Causes / Mechanisms (briefly)

• Hormonal disorders that can lead to menstrual cycle irregularities
• Injuries or damage to the uterine lining
• Polyps or other benign growths in the uterus
• Inflammatory processes of the pelvic organs
• Changes related to pregnancy or the postpartum period

Risk Factors

• Age, especially the period before the onset of menopause
• Presence of chronic diseases or hormonal imbalance
• History of uterine surgeries or curettage procedures
• Use of certain medications that affect blood clotting
• Frequent or complicated pregnancies and deliveries
• Stress and significant lifestyle changes
• Hereditary predisposition to gynecological diseases

Reversible Causes That Should Be Ruled Out

• Infections and inflammations that may provoke bleeding
• Hormonal imbalances that are treatable
• Harmful habits affecting overall health
• Unbalanced or improper nutrition

Uterine bleeding requires careful evaluation by a doctor — only a specialist can determine the causes and risk factors after necessary examinations.

Diagnostics

The diagnosis of uterine bleeding is aimed at identifying possible causes and developing a further plan for examinations and treatment. The physician’s approach is designed so that the patient understands each step and feels supported during the visit.

Diagnostic Approach

• Taking a detailed medical history, including complaints, duration, and characteristics of the bleeding
• Physical examination and gynecological assessment to evaluate the condition of the pelvic organs
• Ordering basic laboratory tests as indicated
• Conducting additional investigations as needed to clarify the cause
• Analyzing the results and formulating a plan for further actions
• Discussing the next steps in examination or treatment with the patient

Typical Tests Based on Indications

May include:

• Ultrasound examination of the pelvic organs
• Hormone blood tests and complete blood count
• Biopsy of the endometrial lining if necessary
• Swabs and tests for infections
• Other procedures prescribed individually by the physician

What to Bring to the Appointment

• Results of previous examinations and tests
• A list of current medications and supplements
• A diary or description of symptoms and bleeding characteristics
• Medical reports and conclusions, if available

The diagnosis of uterine bleeding requires a careful approach, and each case is considered individually at our center.

Treatment

The treatment of uterine bleeding is aimed at reducing symptoms and identifying possible causes for their correction. The therapy plan is tailored individually, taking into account the characteristics of each patient and requires evaluation by a doctor based on indications.

Goals of Therapy

• Reduce the intensity and frequency of bleeding
• Correct the causes that contribute to the development of the problem
• Improve overall well-being and quality of life
• Prevent possible complications and worsening of the condition

Main Treatment Approaches

• May include the use of medications to control bleeding as indicated
• Use of non-pharmacological methods to support the body and improve condition
• Interventions when necessary to eliminate factors affecting bleeding
• Therapy is individualized and selected considering comorbidities and the patient's condition

What the Doctor Does

• Selects and adjusts the treatment plan based on the progress of the condition
• Takes into account all comorbidities and potential risks
• Monitors the appearance of side effects and the effectiveness of therapy
• Explains to the patient the criteria for evaluating results and the next steps
• Coordinates treatment with other specialists if necessary

What to Expect: Plan and Monitoring

• Assessment of the condition and therapy effectiveness is conducted regularly based on indications
• The treatment plan may be adjusted if the desired effect is not achieved or new symptoms appear
• Periodic follow-up visits help monitor progress and prevent complications
• The timing of changes is individual and depends on the specific situation

For detailed information about treatment options for uterine bleeding, please consult with Dr. Irina Ivanovna Kulbach.

Prevention

Prevention plays an important role in reducing the risk of uterine bleeding and helps maintain reproductive system health. The prevention plan is tailored individually and discussed with a physician.

Key Primary Prevention Measures

• Monitoring and timely treatment of hormonal disorders
• Avoidance of harmful habits that worsen health
• Maintaining a healthy weight and balanced diet
• Management of chronic diseases affecting overall health
• Avoiding trauma and injuries to the pelvic organs

Screening and Secondary Prevention / Regular Monitoring

• Regular gynecological examinations as recommended by a doctor
• Monitoring the menstrual cycle and seeking timely medical advice if changes occur
• Screening for inflammatory diseases and infections as indicated
• Monitoring comorbid conditions that increase the risk of bleeding

Practical Tips

• Discuss medication adjustments with your doctor if you have comorbidities
• Keep a symptom diary for more accurate monitoring of your condition
• Maintain moderate physical activity within limits recommended by a specialist
• Avoid stress and overwork; seek support if necessary
• Maintain hygiene and undergo timely examinations as indicated

Prevention of uterine bleeding requires regular attention and cooperation with your physician to choose optimal measures and monitor your condition.

Important to Know

The treatment of uterine bleeding requires a comprehensive approach to identify the actual causes and choose the optimal strategy. Timely consultation with a doctor helps prevent complications and control the condition. Sometimes repeated visits are necessary to monitor progress and adjust the treatment plan. Various factors influence the course of the condition — from physical exertion and stress to comorbidities. Self-medication can mask important symptoms and delay receiving proper care.

• It is important to identify the causes of bleeding, not just temporarily reduce the symptoms
• Early assessment of the condition helps reduce the risk of progression and complications
• Sometimes monitoring and therapy adjustment over time are required for a stable result
• Factors such as stress and chronic diseases can affect the course of bleeding
• Self-treatment can interfere with accurate diagnosis and cause undesirable effects
• Our clinic supports a comprehensive approach and provides support at all stages of treatment

Detailed information about uterine bleeding and its treatment is available on the general page of our website. This will help you better understand the specifics of the problem and prepare for your visit to the doctor.

Self-care Before the Appointment: What You Can and Cannot Do

Before visiting Dr. Irina Ivanovna Kulbach, it is important to take safe steps to manage your condition and avoid causing harm to yourself. If your symptoms worsen or you experience alarming signs, seek medical attention immediately.

What You Can Do Before the Appointment

• Write down when and how the bleeding started, and note any circumstances that affect the symptoms
• Keep a diary recording the intensity and timing of the bleeding
• Bring a list of all medications you are taking, including dosages
• Measure and record your temperature, blood pressure, and pulse if you know how
• Reduce physical activity and allow your body to rest
• Drink plenty of water to prevent dehydration
• Monitor your overall well-being and watch for new symptoms
• Maintain cleanliness and hygiene in the intimate area
• Avoid stressful situations and overexertion whenever possible
• Gather medical documents and results of previous examinations

What You Should Not Do Before the Appointment

• Do not stop or change medications without consulting your doctor
• Do not start taking new medications or combine treatments on your own
• Do not use folk remedies promising quick symptom relief
• Do not ignore worsening symptoms or increasing bleeding
• Do not attempt to interpret test results or examinations by yourself
• Do not delay seeing the doctor if new or intensifying symptoms appear
• Do not use hemostatic agents without a doctor's prescription
• Do not disregard specialist recommendations, even if symptoms temporarily improve
• Do not panic; seek medical help if you feel anxious
• Do not self-medicate if you have comorbid conditions or are pregnant

If you experience signs of an emergency or condition deterioration, be sure to contact Dr. Irina Ivanovna Kulbach immediately.

How I Can Help as a Doctor with Uterine Bleeding Issues

When dealing with uterine bleeding, it is important to receive a comprehensive evaluation and support from a specialist who can help identify the causes and determine the best course of action. During the consultation, I pay close attention to all aspects of your condition to provide you with a clear plan for next steps and ensure your comfort throughout the treatment process.

During a consultation for uterine bleeding, I can assist you in the following ways:

• Analyze your symptoms and medical history to identify possible causes of bleeding
• Assess the severity of symptoms and potential health risks
• Conduct an initial evaluation and differential diagnosis of bleeding causes
• Review current medications and evaluate their tolerance if necessary
• Develop a plan for further steps: investigation, treatment, and follow-up
• Take into account any comorbidities and medications for safe management
• Provide tailored recommendations on lifestyle and daily routine
• Discuss criteria for monitoring progress and when to seek follow-up care
• Adjust therapy if the treatment is ineffective or side effects occur

My goal is to provide attentive care to ensure that your treatment is both effective and comfortable. A plan for observation and monitoring treatment effectiveness allows timely adjustments and helps minimize the risk of complications.

What questions can you ask a doctor about uterine bleeding

During a consultation regarding uterine bleeding, you can discuss the following issues with Dr. Irina Ivanovna Kulbach:

• Irregular or increased bleeding between periods
• Heavy menstruation interfering with daily life
• Bleeding after sexual intercourse or outside the menstrual cycle
• Recurrent bleeding that does not stop or keeps coming back
• Pain in the lower abdomen accompanied by bleeding
• No improvement from previously prescribed treatment
• Need for a second opinion on test results
• Presence of other medical conditions that may affect bleeding

In case of sudden heavy bleeding, sharp deterioration of condition, or loss of consciousness, seek emergency medical help immediately—do not wait for a scheduled appointment.

Frequently asked questions during the consultation:

• What is happening to me and what could it be?
• Why has the bleeding started now?
• How can I understand if this is related to uterine bleeding or something else?
• What examinations are necessary in my particular case?
• Which tests and investigations are essential, and which can be skipped?
• How should I best prepare for the tests and the appointment?
• What treatment options are available and how do they differ?
• Can this condition be completely cured or can it become chronic?
• What should I do if the prescribed treatment does not work?
• Is it possible to manage without medication or surgery?
• How long does treatment usually take and how often is follow-up needed?
• What signs show that the condition is improving or worsening?
• What should I do in case of sudden worsening or symptom flare-up?

For any urgent symptoms, seek immediate medical assistance. During the consultation, the doctor will help you understand your condition, identify important areas for investigation, and develop an appropriate treatment plan.

How the Consultation Proceeds

A consultation with an obstetrician-gynecologist regarding uterine bleeding involves reviewing complaints, assessing the condition, and developing a plan for further actions. The scope of necessary examinations is determined individually, based on indications, and depends on the specific situation. A precise diagnosis is not made during a single visit, but a preliminary assessment is performed and recommendations are provided.

1. Clarifying complaints and the purpose of the visit: finding out what exactly is troubling the patient, when the symptoms started, how they affect daily life, and what the patient's expectations are.
2. Collecting medical history and risk factors: clarifying previous issues, the presence of chronic diseases, and health characteristics.
3. Discussing previous examinations and treatments: analyzing any previously conducted tests and procedures, with recommendations to bring results and a list of medications.
4. Conducting an examination and basic tests as indicated to assess the condition of the pelvic organs and overall health status.
5. Forming a preliminary conclusion: identifying probable causes and ruling out possible dangerous conditions without establishing a final diagnosis.
6. Planning necessary additional investigations, which may include ultrasound, blood tests, infection swabs, and other procedures as indicated.
7. Discussing general principles of treatment and management — what the therapy involves and how monitoring will be conducted.
8. Determining follow-up timing and recommendations for repeat visits, as well as explaining when to seek care earlier if the condition changes.

If this is your first visit, the consultation will focus on thoroughly collecting information and searching for possible causes of the bleeding. If previous treatment was unsuccessful, special attention is given to analyzing reasons for the lack of effect and adjusting the management plan.

This approach helps build trust and ensures comfortable and safe care for your condition within the clinic.

Preparation for the Appointment

To ensure an effective consultation with the obstetrician-gynecologist regarding uterine bleeding, it is important to prepare properly. This will speed up the diagnosis and help the doctor develop an accurate treatment plan.

• Bring a list of all current medications (names, dosages, how you take them).
• Take previous examination results with you: ultrasound, blood tests, swabs, and any other available documents.
• Write down your main complaints: when symptoms started, what worsens or alleviates your condition.
• Do not stop taking prescribed medications without consulting your doctor.
• If recommended, come fasting: do not eat or drink for at least 8 hours (if otherwise advised, clarify at the time of booking).
• Avoid using cosmetics or creams in the examination area, if required.
• Prepare a list of questions or concerns you want to discuss with the doctor.
• If possible, make notes about your daily routine, physical activity, stress, and related symptoms.
• Bring contact details of previous doctors or clinics, if there is a need to clarify your medical history.
• If you are unsure about preparation, clarify the details when scheduling your appointment.

If you have questions before your visit, we recommend checking with the registration desk and not changing your medication regimen without consulting a specialist.

About the Doctor

Irina Ivanovna Kulbach is a highly qualified obstetrician-gynecologist with over 40 years of experience. She works with patients experiencing uterine bleeding, including those with primary symptoms, recurrent episodes, and chronic conditions. She pays special attention to the differential diagnosis of causes and the selection of therapy, taking into account comorbidities. During the consultation, you will receive a clear analysis of your situation and recommendations for further monitoring and treatment.

Why Patients Choose Dr. Irina Ivanovna Kulbach

Choosing a doctor for the treatment of uterine bleeding depends not only on experience but also on the approach to the process and the quality of service. Dr. Irina Ivanovna Kulbach bases her work on consistent diagnosis of the causes and careful monitoring of the condition’s dynamics. Safety of therapy is especially important in her practice, particularly when there are comorbidities. Patients appreciate her ability to explain the treatment plan in clear language and adjust the strategy as needed. The possibility to come to an appointment with existing test results saves time and speeds up the selection of the optimal solution.

• Clear action plan: what to do now, how to evaluate results, and when to come for a follow-up
• Examinations only as indicated, without unnecessary procedures, reducing the patient’s burden
• Consideration of comorbidities and medications to ensure safe and effective treatment of bleeding
• Monitoring symptom dynamics and adjusting treatment if there are no effects or side effects
• Review and interpretation of previous examinations for a more comprehensive understanding of the situation
• Explaining therapy goals, possible risks, and alternatives to the patient without complex terminology
• Attention to preventing complications and exacerbations for long-term stabilizing effect
• Experience managing complex cases with recurring symptoms and patients with multiple diagnoses

This approach helps patients feel confident and receive consistent support at every stage of uterine bleeding treatment.

Case Studies

Initial Consultation for Irregular Bleeding

A middle-aged patient presented with complaints of irregular spotting and lower abdominal pain. It was important to rule out serious conditions and identify the cause of the changes, as the symptoms were new and worrying. A comprehensive assessment was conducted, including medical history, physical examination, and additional investigations as indicated. Over time, the symptoms became less severe, and the condition stabilized. The patient is now under regular follow-up with monitoring and adjustments to recommendations as needed.

Treatment Adjustment Due to Lack of Effect from Previous Therapy

A young woman with a long history of uterine bleeding reported continuous bleeding despite prior treatment at another clinic. It was essential to carefully review previous prescriptions, evaluate possible causes of ineffectiveness, and select a new management approach. After detailed analysis and clarification of the history, the monitoring and treatment plan were revised. At follow-up, improvements in quality of life and symptom reduction were noted, and ongoing dynamic observation continues.

Chronic Course with Comorbidities

An elderly patient with chronic uterine bleeding and multiple comorbid diagnoses sought comprehensive management. Special attention was given to potential drug interactions and the overall condition of the patient. All current medications and chronic illnesses were reviewed to ensure safe treatment adjustments. The course showed stabilization, and a supportive strategy with regular monitoring and prevention of possible exacerbations was implemented.

Exacerbation Associated with Stress and Lifestyle Changes

A middle-aged woman presented with worsening uterine bleeding after a period of significant stress and increased workload. It was important to assess the impact of external factors and promptly adjust the management plan to reduce risks. Complaint evaluation, additional testing, and therapy adaptation were performed considering the current situation. At the next visit, a decrease in bleeding and improved general condition were observed. Continued monitoring and attention to preventive measures were recommended.

Second Opinion and Analysis of a Complex Case

A patient with a long history of ambiguous diagnostic results sought a second opinion. The primary goal was to evaluate the completeness of previous examinations and clarify the diagnosis to exclude serious pathology. A thorough review of the medical history and test results was conducted, and additional investigations were ordered as indicated. During the follow-up appointment, the findings were discussed, and a plan for further management and monitoring was formulated. The patient received explanations and support for confident management of her condition.

How long does a consultation for uterine bleeding last?

The consultation usually lasts from 30 to 60 minutes. Please check the exact duration when making an appointment.

How should I prepare for an appointment with an obstetrician-gynecologist?

Preparation includes gathering information about your symptoms and current medications. More details can be found in the preparation section.

What should I bring to the consultation?

Bring the results of any previous examinations, a list of medications you are taking, and notes about your symptoms.

Do I need to come fasting to the appointment?

Usually no, unless otherwise specified at the time of booking.

How many visits are usually required for treatment?

The number of visits depends on the complexity of the situation and the chosen therapy. Several appointments are often needed for monitoring.

When can I expect the first results of the treatment?

The first changes are assessed individually, depending on the selected approach and your condition.

What should I do if symptoms worsen before the appointment?

If you experience heavy bleeding, pain, or worsening condition, seek emergency care immediately; do not self-medicate.

Can treatment be combined with current medications?

It is best to discuss this with the doctor during the appointment. Do not change or stop medications on your own.

Is it possible to have an online consultation?

Yes, online consultations are available by appointment and are suitable for initial evaluations and consultations.

Can I come with already completed examinations?

Yes, bring all available results for a more thorough analysis of your situation.

Do I need to come back for follow-up visits?

Yes, follow-up visits are important for assessing progress and adjusting treatment. The frequency is discussed individually.

Can I get a second opinion from this doctor?

Yes, the doctor is willing to review previous examinations and prescriptions to clarify diagnosis and treatment strategy.

What should I do if symptoms return after improvement?

If your condition worsens, it is recommended to consult again for treatment adjustment and additional examinations.

Which examinations are mandatory?

The list of examinations depends on symptoms and medical history and is discussed individually during the appointment.

Can I come to the appointment during menstruation or bleeding?

If bleeding is heavy, it is better to consult beforehand. For light bleeding, the appointment is usually possible.

How often should ultrasound be done for uterine bleeding?

The frequency of ultrasound examinations is determined by the doctor based on indications and previous results.

Can I take painkillers before the appointment?

If they usually help you, you may take them, but discuss this with your doctor for safety.

What should I do if I feel anxious or fearful before the visit?

Share your concerns with the doctor. They will help you understand the situation and support you throughout the examination and treatment process.