Abnormal Vaginal Bleeding: Causes and Treatment

What is Abnormal Bleeding?

Abnormal vaginal bleeding is any vaginal bleeding that happens unexpectedly. It refers to vaginal bleeding that occurs outside of your expected menstrual cycle or a menstrual cycle that suddenly changes in nature. Abnormal vaginal bleeding may include:

Bleeding at Unusual Times – Such as between periods or after intercourse
Heavy Menstrual Periods – Outside of what is ‘normal’ for your situation. Heavy menstrual bleeding can be defined as soaking through one or more sanitary pads or tampons every hour for several consecutive hours
Long Menstrual Periods – Periods usually last 4-7 days. Anything longer than seven days is considered abnormal
Erratic Menstrual Cycle – This refers to menstrual cycles that are very inconsistent. However, an irregular menstrual period may be seen in conditions such as polycystic ovarian syndrome (PCOS).

Most women will experience at least one episode of abnormal bleeding in their lives. By itself, abnormal vaginal bleeding does not necessarily indicate a serious problem or condition. But in the presence of ongoing abnormal vaginal bleeding, recurring episodes of abnormal bleeding, or in the background of other medical issues, it should not be ignored. Any abnormal bleeding should always be discussed with your doctor.

Common Causes

Uterine Fibroids

Uterine fibroids are non-cancerous growths of the uterus that often appear in women during their reproductive years. In situations where fibroids cause symptoms, these may present as heavy menstrual bleeding, severe menstrual cramps, or bleeding between periods. Fibroids can be diagnosed with an ultrasound scan and, depending on the severity, be treated by medication, watchful waiting, or surgery.

Endometriosis

Endometriosis is a medical condition in which cells that normally line the inside of the uterus (the endometrium) begin to grow on the outside of the uterus instead. Endometriosis can lead to heavy bleeding during your menstrual cycle. Some women may also notice pelvic pain and cramping. Endometriosis can be diagnosed with a scan or by an investigation known as. Treatment options usually involve medication or surgery. The approach you and your doctor choose to take will depend on how severe your signs and symptoms are and whether you hope to become pregnant.

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a medical condition caused by an imbalance of the reproductive hormones estrogen and progesterone. In PCOS, regular regulation of these hormones becomes disrupted, which can lead to symptoms of irregular periods (i.e., infrequent, heavy, or prolonged menstrual cycle), acne, excess facial and body hair, weight gain, or infertility. The treatment for PCOS is specific to each woman. It will depend on your past medical history, medication history, and lifestyle.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is the infection of a woman’s reproductive organs. It is a complication often caused by sexually transmitted infections such as chlamydia or gonorrhea. PID is a serious medical condition that should be treated by a doctor as soon as possible. Symptoms of PID include pain in the lower abdomen, a high temperature, a burning sensation when passing urine, and bleeding between periods.

Sexually Transmitted Infections

In some cases, sexually transmitted infections (STIs) such as chlamydia and gonorrhea may cause abnormal vaginal bleeding. If an STI is present, vaginal bleeding may be experienced alongside other symptoms, such as abnormal vaginal discharge and itching or rashes in the vaginal area. STIs should always be treated immediately. Untreated STIs can lead to long-term complications.

Non-Sexually Transmitted Infections

Infection or inflammation of the vagina, known as vaginitis, may cause abnormal vaginal bleeding. Vaginitis is a term used to describe various disorders that cause inflammation or infection of the vagina. Culprits of inflammation or infection range from organisms such as yeast to irritants like chemicals or sprays.

Cancer

The vast majority of abnormal bleeding events will not be related to cancer. However, in a small number of cases, abnormal vaginal bleeding may be linked to cancer of the uterus, cervix, ovaries or vagina. For this reason, all cases of abnormal vaginal bleeding must be taken seriously and discussed with a medical professional.

Other Causes

Medications – Some medications, such as birth control pills or hormone replacement therapy, can cause abnormal vaginal bleeding.

Possible pregnancy – Women may experience episodes of light vaginal bleeding in the early stages of pregnancy. If pregnancy is a possibility, a home pregnancy test can be taken.

Diagnosis

All cases of abnormal vaginal bleeding should be discussed as a matter of priority with your doctor. Your doctor will take a full medical history and perform a physical exam to help determine the underlying cause of the bleeding. Additionally, they may order diagnostic tests, such as a blood test or ultrasound scan, to help rule out other possible factors.

Treatment

Your specific diagnosis will determine the treatment of abnormal vaginal bleeding. Once a diagnosis is given, treatment options can be discussed with your doctor in detail. Your medical history, current medication history, and unique circumstances will always guide treatment.

Special considerations

Post-menopausal Women – Post-menopausal women who experience any vaginal bleeding should see their doctor immediately. After menopause, menstrual cycles should come to a complete stop. Therefore, a doctor should always investigate any bleeding after this time.

Pregnancy and Abnormal Vaginal Bleeding – Pregnant women who experience any bleeding should seek advice from their doctor as soon as possible. Although not all bleeding that is experienced during pregnancy is harmful, any bleeding episodes should always be discussed with a medical professional.

Abnormal vaginal bleeding should not be ignored. Regardless of the potential cause or how long it has been going on, vaginal bleeding should always be investigated. If in doubt, make an appointment just to be on the safe side!