"Sometimes you can have a condition called Adenomyosis, which is also seen on ultrasound. Adenomyosis is when the glands, which is the insight layer or the endometrium, goes into the muscle. I always like to think of it like this. Normally the uterus is made of three layers, the endometrium, the myometrium and the serosa, which is the outside covering. Endometrium is the glands. And that's what builds up and sloughs off when you have a period. The myometrium is the muscle. That's what makes you contract and cramp. And the serosa, it doesn't really do anything. Just kind of protects the, the organ. So what happens is that normally, your neighbors, they're living in their own neighborhood, we're next to each other, but we're minding our own business. You do your thing. I do my thing. We're good. But occasionally when you have Adenomyosis, it doesn't work that way, the glands are rude, annoying neighbors, and they go into the muscle and your body's like, hmm, I don't like that. And so you have some irregular bleeding. And so that is not supposed to be, they're supposed to be doing their own thing. And when the glands go into their muscle, that can make you have heavy bleeding as well. Those are the most common issues that can occur with heavy bleeding. When we check your blood, if when we do your CBC, or if you have a history of bleeding condition, you can have a bleeding disorder, like Von Willebrand's disease or something to that nature that makes you have heavy periods, or some kind of hemophilia, those things are less common, but they can occur too. So there are a spectrum of things that we're looking for when a person presents with bleeding. Occasionally we don't find anything. Your labs look totally normal. Your uterus looks totally normal. Your exam looks totally normal. And then it's the type of dysfunctional bleeding that we don't have an actual cause for. But there are options for treatment."