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Fibroids & Abnormal Bleeding
Heavy periods are common. That does not make them normal.
Bleeding through a pad in an hour, planning your week around your cycle, and being told it is just how you are built. Fibroids, polyps and abnormal bleeding are evaluated here with ultrasound performed by Dr. Kim, and most of the treatment happens here too.
Your physician
The person who scans you is the person who would operate.
There is a difference between a radiologist describing a fibroid and a surgeon looking at one. Size and count matter less than position — and position is what determines whether bleeding can be treated in the office, through a hysteroscope, or laparoscopically.
- ExperienceNearly 30 years in obstetrics & gynecology
- Cedars-Sinai Medical Center15 years · OB/GYN residency faculty
- American Board of Obstetrics & GynecologyOral board examiner
- Los Angeles Magazine Top Doctor2020–2024 · 2026
What we evaluate and treat
From the first scan to the operating room, without changing physicians.
Abnormal bleeding has a short list of common causes, and telling them apart is what the evaluation is for. Fibroids are the most familiar, but polyps, adenomyosis, hormonal causes and endometrial changes all present the same way in the waiting room.
Uterine fibroids
- Fibroid evaluation with ultrasound performed by Dr. Kim, in the office, and read with you while he is looking at the screen.
- Where fibroids sit matters more than how many there are. Those inside the cavity cause bleeding; those on the outside more often cause pressure.
- Not every fibroid needs treating. If yours is not causing symptoms and is not affecting fertility, watching it is a legitimate plan and we will say so.
- When treatment is warranted, options run from medical management to myomectomy, with fertility-preserving approaches discussed first for patients who want them.
Heavy and abnormal periods
- Bleeding is abnormal when it disrupts your life — soaking through protection hourly, passing large clots, bleeding between periods, or cycles that have changed from your normal.
- Evaluation includes ultrasound, and bloodwork for anemia, thyroid and hormonal causes.
- Iron deficiency is often the part nobody addressed. Years of heavy periods leave many patients tired in a way they have stopped attributing to their cycle.
- Bleeding after menopause is always evaluated, and promptly. It is usually not cancer, but it is not something to watch.
Uterine polyps
- Polyps are a common and very treatable cause of bleeding between periods and of bleeding after menopause.
- They are often missed on a standard ultrasound and seen clearly on saline infusion sonohysterography, which is performed here in the office.
- Removal is usually hysteroscopic — through the cervix, with no incision.
- Polyps can also affect implantation, which matters if you are trying to conceive. See fertility care.
Endometrial ablation and what comes after
- Endometrial ablation treats heavy bleeding without removing the uterus, for patients who are finished having children.
- It is not appropriate for everyone. It is not a treatment for fibroids inside the cavity, and it is not contraception.
- Hysterectomy is not the default here. It is one option among several, and it is discussed as such rather than presented as the end of the road.
- Whatever the plan, the physician who evaluated you is the one who performs it — see gynecologic surgery.
How long have you been managing this?
Most patients we see for heavy bleeding have been living with it for years. The evaluation is one visit and an ultrasound.
What to expect
How the evaluation works.
- The first visitHistory, exam, and a pelvic ultrasound performed by Dr. Kim in the office. You see what he sees and hear what it means the same day.
- BloodworkUsually a blood count for anemia, plus thyroid and hormonal testing depending on the pattern of bleeding.
- A closer look, if neededSaline infusion sonohysterography or office hysteroscopy when the cavity needs to be seen directly. Both are done here.
- A plan with optionsWatchful waiting, medical management, an office procedure, or surgery — with what each one costs you in recovery time, and what it means for fertility.
- If surgery is the answerDr. Kim performs it, at Cedars-Sinai. You do not start over with a surgeon who has never met you.
This page is general information and is not medical advice. Any bleeding after menopause, or bleeding heavy enough to make you lightheaded, should be evaluated promptly.
Explained
Fibroids and abnormal bleeding, explained.
What each condition is, how it is diagnosed, and what the treatment options actually involve.
Uterine fibroids
Uterine fibroids are benign growths of the muscular wall of the uterus. They are extremely common, they are not cancer, and many cause no symptoms at all. When they do, the usual complaints are heavy bleeding, pelvic pressure, frequent urination, or difficulty conceiving.
Where a fibroid sits matters more than how many there are. Submucosal fibroids, which bulge into the cavity, are the ones most likely to cause heavy bleeding and to affect implantation. Subserosal fibroids on the outer surface more often cause pressure symptoms.
Fibroid evaluation
Evaluation begins with a pelvic and transvaginal ultrasound performed by Dr. Kim in the office, mapping size, number and position. Bloodwork checks for anemia, which years of heavy periods commonly cause and which patients often attribute to something else.
Where the cavity needs to be seen directly, saline infusion sonohysterography or office hysteroscopy is used. Both are done here rather than at an imaging centre, and the findings are explained during the appointment.
Heavy and abnormal periods
Bleeding is worth evaluating when it soaks through protection hourly, includes clots larger than a quarter, lasts longer than a week, occurs between periods, or has changed from what is normal for you.
Fibroids are one cause among several. Polyps, adenomyosis, thyroid and hormonal conditions, bleeding disorders and changes in the uterine lining all present the same way, which is why the evaluation looks at all of them rather than stopping at the first finding on a scan.
Uterine polyps
Endometrial polyps are soft overgrowths of the uterine lining. They are a common cause of bleeding between periods and of bleeding after menopause, and they can interfere with implantation in patients trying to conceive.
Polyps are frequently missed on a standard ultrasound and seen clearly with saline infusion sonohysterography. Removal is usually hysteroscopic — through the cervix, with no incision — and is often a short outpatient procedure.
Endometrial ablation
Endometrial ablation treats the lining of the uterus to reduce heavy menstrual bleeding while leaving the uterus in place. For appropriate candidates it is a shorter procedure with a faster recovery than hysterectomy.
It is intended for patients who have completed childbearing, it is not a form of contraception, and it is not a treatment for fibroids inside the cavity. Whether it fits your situation depends on the cause of the bleeding, which is what the evaluation establishes first.
Questions
What patients ask first.
Do all fibroids need to be treated?
No. Many fibroids cause no symptoms and need nothing more than monitoring. Treatment is driven by symptoms, by growth, and by whether the fibroid is affecting fertility — not by its existence on a scan.
Will I need a hysterectomy?
Usually not. Hysterectomy is one option among several, and for many patients a hysteroscopic or laparoscopic procedure that preserves the uterus is appropriate. If you want to preserve fertility, say so at the first visit — it changes which options are on the table.
How do I know if my periods are heavy enough to be a problem?
If you are soaking through a pad or tampon every hour, passing clots larger than a quarter, bleeding longer than a week, or planning your life around your cycle, that is worth evaluating. Fatigue from iron deficiency is another sign patients often miss.
I am bleeding after menopause. Should I be worried?
It should be evaluated promptly. Most causes are benign — thinning of the lining, or a polyp — but postmenopausal bleeding is one of the few gynecologic symptoms that is never watched and waited on.
Is endometrial ablation the same as a hysterectomy?
No. Ablation treats the lining of the uterus to reduce bleeding and leaves the uterus in place. It is intended for patients who have finished having children, it is not contraception, and it is not a treatment for fibroids inside the cavity.
Can fibroids turn into cancer?
Very rarely. The overwhelming majority of fibroids are benign and remain so. Rapid growth, particularly after menopause, is the finding that prompts closer evaluation.
Can fibroids affect fertility?
Some can, particularly those that distort the uterine cavity. Many do not. If you are trying to conceive, say so at the first visit, because it changes both whether a fibroid is treated and how.
Where can I get fibroid treatment in Los Angeles?
Yunella Women's Health provides fibroid evaluation and treatment on San Vicente Boulevard in Los Angeles, with in-office ultrasound and surgery performed by Dr. Kim at Cedars-Sinai Medical Center.
More on coverage and cost: Insurance & Payment. General questions: FAQs.
Start here
You do not have to plan your life around your cycle.
One visit and an ultrasound is usually enough to know what is causing it and what can be done.
Or call (424) 404-8832 · 6330 San Vicente Blvd, Suite 418, Los Angeles, CA 90048