Possible causes of vaginal bleeding include placenta previa, miscarriage, ovulation abnormalities, and mid-cycle hormonal changes, oral medications, IUDs or other foreign bodies, PCOS, pelvic inflammatory disease (PID), STDs or STIs, and perimenopause. Less common causes include sexual assault, fibroids, prolapse, or polyps, stress, cancer, and hyperthyroidism, and diabetes. When one experiences abnormal bleeding, the doctor may ask:
- If you are pregnant
- What is the pattern of the bleeding
- Whether the bleeding is sudden or frequent
- How long does the bleeding last
- If you are ovulating
- If there is any associated pelvic pain
If you are experiencing heaving bleeding, and are using more than one pad per hour, either with or without clots, then you should call your doctor and go to the hospital. While in the ER, usually patients are given a high dose of estrogen and progesterone to decrease and stop the heavy periods.
After seeking medical attention, a gynecologist in Cleveland may suggest different treatment options for your heavy menstrual bleeding. 
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