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June is <\/em><\/em>National Cancer Survivors Month<\/em><\/em><\/a> and <\/em><\/em>Uterine Cancer Awareness Month<\/em><\/em><\/a>.<\/em><\/em><\/p>\n When heavy vaginal bleeding sent Julie Herbert to a California emergency room in November 2024, cancer was the furthest thing from her mind. A triage nurse at the hospital was very concerned, and the 36-year-old research associate was quickly admitted. <\/p>\n \u201cThey immediately put me into a room and gave me IV fluids and a blood transfusion,\u201d Herbert said.<\/p>\n A Pap test<\/a> administered by the hospital came back abnormal. <\/p>\n After follow-up testing, including a CT scan, an ultrasound and a biopsy, Herbert was diagnosed with advanced cervical cancer that had spread to her lymph nodes.<\/p>\n \u201cWhen they told me it was cancer, I was stunned,\u201d she said.<\/p>\n After all, seven days earlier, she had seen a gynecologist for abnormal bleeding. Herbert said the doctor had attributed this to heavy menstrual periods and the recent removal of her intrauterine device (IUD)<\/a>, and did not order any follow-up testing. <\/p>\n Herbert \u2014 who\u2019d been using an IUD<\/a> for eight years \u2014 had had the device removed three months earlier. She\u2019d experienced some bleeding on and off before it was removed, but it got worse after it was taken out. <\/p>\n Bleeding can occur when an IUD is removed, but excessive, prolonged bleeding after a removal may indicate a more serious underlying medical condition<\/a>.<\/p>\n Given her history of bleeding and the intensity of it, Herbert believes the medical professionals that she saw should have done more.<\/p>\n \u201cThey said this could just be my body getting back to normal after getting the IUD out and blamed it on my hormones,\u201d Herbert said. <\/p>\n Herbert\u2019s experience is not uncommon.<\/p>\n Abnormal<\/a> vaginal bleeding \u2014 or abnormal uterine bleeding (AUB) when it originates in the uterus \u2014 affects up to 35% of women and is defined as bleeding that is unexpected or prolonged, including extremely heavy periods or irregular bleeding not related to menstruation.<\/p>\n But despite its prevalence, and the fact that abnormal bleeding is a common symptom of gynecologiccal cancers, it is frequently overlooked or attributed to fibroids<\/a>, hormones, irregular periods, birth control or cervical polyps<\/a> \u2014 potentially leading to a missed diagnosis of a more serious problem.<\/p>\n \u201cCancer can happen to anyone, and my bleeding was not taken as seriously as it should have been,\u201d Herbert said.<\/p>\n<\/div>\n Medical gaslighting<\/a> \u2014 when medical providers invalidate or dismiss patients\u2019 questions, symptoms or concerns \u2014 is a significant issue in women’s health, particularly in cancer care<\/a>. This can happen with all patients, but marginalized communities are often particularly affected<\/a>.<\/p>\n A study<\/a> published in BMC Women\u2019s Health found that women have \u201cconsistently reported poor experiences in accessing care\u201d for abnormal uterine bleeding throughout the last 20 years.<\/p>\n Elena Ratner, M.D.<\/a>, a gynecologic oncologist at Yale Cancer Center, said that she frequently has patients come to her after they have seen numerous other medical providers who did not address their unexpected bleeding.<\/p>\n \u201cAbnormal bleeding is a tangible, clear symptom that should not be ignored, yet women are not being listened to,\u201d Ratner said.<\/p>\n Abnormal bleeding can happen for many different reasons and is not always a sign of cancer, Ratner explained. \u201cHowever, it is essential that patients are properly evaluated to determine the cause, particularly since early diagnosis is crucial for gynecological cancers,\u201d she added. <\/p>\n<\/div>\n Several recent studies<\/a> have found<\/a> a gender pain bias, where medical providers assume women are exaggerating their pain.<\/p>\n Menstrual pain and bleeding are also frequently<\/a> seen as an inevitable experience for women, which leads to symptoms not being taken as seriously \u2014 even though tumors on the uterus and ovaries<\/a> can cause pressure and pain that are similar to menstrual cramps. <\/p>\n Ami Vaidya, M.D.<\/a>, an oncologist and co-chief of the Division of Gynecologic Oncology at Hackensack Meridian John Theurer Cancer Center, said that the ongoing normalization of menstrual-related pain and bleeding can cause patients to delay seeking help and may lead healthcare providers (HCPs) to overlook symptoms of a critical medical issue. <\/p>\n \u201cThere is a significant and well-documented misconception in medicine where abnormal bleeding is sometimes dismissed as a normal part of \u2018being a woman,\u2019 which can lead to missed or delayed diagnoses of serious conditions,\u201d said Vaidya. <\/p>\n Despite diagnostic challenges, experts emphasize there are specific symptoms<\/a> to gynecologic cancers that patients should be aware of and speak with their provider about, including: <\/p>\n Vaidya said there are different diagnostic exams that patients can discuss with their HCP that may help determine the cause of abnormal bleeding, including:<\/p>\n Vaidya recommends that patients keep a symptom journal to track any pain and\/or bleeding and bring a list of questions to their medical appointments.<\/p>\n \u201cIf you feel dismissed, ask pointed questions such as, \u2018What specific tests can we run to rule out more serious conditions like cancer?\u2019 If a requested test is denied, insist that the doctor document the refusal in your chart \u2014 a step that often prompts action,\u201d she said.<\/p>\n<\/div>\n Abnormal bleeding can frequently be dismissed<\/a> in younger patients because providers often assume they\u2019re too young to have cancer. A 2025 study<\/a> found that younger women encounter lengthy diagnostic delays, often due to the assumption that their symptoms are not caused by something serious.<\/p>\n Herbert said she thinks being in her 30s contributed to the dismissal of her symptoms. <\/p>\n \u201cI definitely think my age played a role. It finally took one female doctor to listen to me, take my whole medical history, and say, \u2018This isn\u2019t right and we need to do more tests,\u2019\u201d said Herbert. <\/p>\n For patients who are going through menopause<\/a> or are postmenopausal, they can also experience delays in diagnosis. <\/p>\n Early gynecologic cancer symptoms can frequently be attributed<\/a> to menopause symptoms or the normal aging process. Missed preventive screenings can also play a role due to the misconception<\/a> that regular pelvic exams may not be necessary if a patient is no longer in their reproductive years or menstruating.<\/p>\n Vadiya added that annual pelvic exams to check for uterine or ovarian abnormalities, even if patients are no longer menstruating, are still a crucial preventive test.<\/p>\n<\/div>\n Ratner asserts that patients have the right to receive comprehensive care that addresses their medical needs.<\/p>\n \u201cPatients know their own bodies, and if they know something is wrong and they don’t get the care they feel is right for them, they should leave and find a provider who does listen. Demand what you deserve,\u201d she said.<\/p>\n For Herbert, after nearly a year of treatment, her cancer went into remission \u2014 an occasion she commemorated by getting a watercolor phoenix tattoo.<\/p>\n Herbert, who plans to get more involved in the cancer support community and help patients connect with resources, said it is important for patients to find a provider who won\u2019t dismiss their bleeding. <\/p>\n \u201cBe proactive about the problem and know that you have the right to be heard and have your concerns taken seriously.”<\/p>\n<\/div>\n\nIgnoring abnormal bleeding can have serious consequences<\/strong><\/h3>\n
\nMedical gaslighting compounds the problem<\/strong><\/h3>\n
\nWomen\u2019s pain has been normalized <\/strong><\/h3>\n
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\nAge bias contributes to diagnosis delays <\/strong><\/h3>\n
\nBe vigilant<\/strong><\/h3>\n