Vaginal Bleeding

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Introduction

What is vaginal bleeding?

Vaginal bleeding is bleeding that flows from the vagina. Bleeding can originate in the vagina, cervix or uterus.

Abnormal or unexpected vaginal bleeding that occurs outside your normal menstrual cycle or causes extreme symptoms during your period can be caused by a wide variety of abnormal conditions, including hormonal imbalances, infection, complications of pregnancy, malignancy, trauma, and certain medications. However, many underlying causes of abnormal vaginal bleeding, such as vaginal dryness and cervical dysplasia, are very treatable if promptly diagnosed and treated.

Treatment of vaginal bleeding varies and is tailored to the individual case, the underlying cause, the severity of symptoms, and the presence of any complications.

Sometimes bloody urine, which is due to bleeding from the urinary tract, or bloody stools, which is due to bleeding from the gastrointestinal tract, can be mistaken for vaginal bleeding. Any unexplained bleeding should be evaluated by your health care professional.

Some types of vaginal bleeding can be caused by serious, even life-threatening conditions, such as an ectopic pregnancy, uterine cancer, or pelvic inflammatory disease. Seek prompt medical care if you have vaginal bleeding that is different than your normal menstrual period. Early diagnosis and treatment of vaginal bleeding reduces the risk of serious complications, such as infertility and metastatic uterine cancer.

Seek immediate medical care (call 911) if you, or someone you are with, are pregnant and have vaginal bleeding or abdominal pain.

What are the different types of vaginal bleeding?

Vaginal bleeding can be described in various terms, such as vaginal bleeding after menopause and oligomenorrhea. The terms applied to vaginal bleeding include:  

  • Bloody vaginal discharge

  • Dysfunctional uterine bleeding, a general term for abnormal uterine bleeding that is not caused by the menstrual cycle

  • Menorrhagia, unusually heavy menstrual periods

  • Menstrual bleeding, vaginal bleeding that occurs due to a normal menstrual period

  • Oligomenorrhea, which is menstrual bleeding that occurs more than 35 days after the last menstrual period (less than 10 periods a year)

  • Polymenorrhea, which is menstrual bleeding that occurs less than 21 days after the last menstrual period (more than 12 periods a year)

  • Spotting, a type of vaginal bleeding that is light and irregular

  • Vaginal bleeding after intercourse

  • Vaginal bleeding after menopause

  • Vaginal bleeding during pregnancy or labor

  • Vaginal hemorrhage, which is very heavy vaginal bleeding

Symptoms

What other symptoms might occur with vaginal bleeding?

Vaginal bleeding may occur with other symptoms that vary depending on the underlying disease, disorder or condition. For example, excessive vaginal bleeding due to hemophilia (a bleeding disorder) may occur in conjunction with other bleeding symptoms, such as difficulty controlling bleeding from a small hand laceration.

Symptoms that may occur along with vaginal bleeding

Vaginal bleeding may occur with other symptoms including:

Symptoms that might indicate a serious or life-threatening condition

In some cases, vaginal bleeding can be caused by or lead to a serious condition, such as miscarriage, anemia, pelvic inflammatory disease, or uterine cancer. Seek prompt medical care if you, or someone you are with, have any of the following symptoms:

  • Pelvic or abdominal pain

  • Periods that are heavier or longer than usual

  • Unusual vaginal bleeding

  • Vaginal bleeding after menopause

Seek immediate medical care (call 911) if you experience:

  • Dizziness or feeling faint

  • High fever (higher than 101 degrees)

  • Severe pelvic or abdominal pain

  • Vaginal bleeding during pregnancy

Causes

What causes vaginal bleeding?

Normal vaginal bleeding occurs every 21 to 35 days during menstruation. Your menstrual period may last for just a few days or for more than a week. A normal menstrual flow can differ greatly from woman to woman and also varies in different phases of life, such as adolescence and perimenopause. Abnormal vaginal bleeding can be due to a range of different conditions, from mild vaginal irritation during sexual intercourse to a serious or life-threatening condition, such as cervical cancer, an ectopic pregnancy, or pelvic inflammatory disease (PID).

Common causes of vaginal bleeding

Abnormal vaginal bleeding can be caused by a variety of diseases, disorders or conditions that affect the vagina, cervix, ovaries or uterus. Common causes of abnormal vaginal bleeding include:

    What are the potential complications of vaginal bleeding?

    In some cases, vaginal bleeding can be due to a condition associated with serious or life-threatening complications. You can minimize the risk of serious complications of vaginal bleeding by seeking early medical care and following the treatment plan you and your health care professional design specifically for you. Complications of vaginal bleeding and its underlying cause can include:

    • Adverse effects of treatment

    • Anemia, due to excessive blood loss

    • Chronic pelvic pain

    • Difficulty getting pregnant and infertility

    • Ectopic pregnancy

    • Metastatic cancer that can become terminal

    • Pelvic adhesions and scarring of the fallopian tubes

    • Progression of symptoms

    • Severe hemorrhage

    • Spread of infection

    • Transmission of STDs

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2018 Dec 21
    1. What are menstrual Irregularities? National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health & Human Development. http://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/Pages/irregularities.aspx
    2. Vaginal Bleeding. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003156.htm
    3. Lockwood CJ. Mechanisms of normal and abnormal endometrial bleeding. Menopause 2011; 18:408.
    4. APGO educational series on women's health issues. Clinical management of abnormal uterine bleeding. Association of Professors of Gynecology and Obstetrics, 2006.
    5. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
    6. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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