BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuVaginal or uterine bleedingIrregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleedingVaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different.Most women have cycles between 24 and 34 days apart. It usually lasts 4 to 7 days in most cases. Young girls may get their periods anywhere from 21 to 45 days or more apart. Women in their 40s will often notice their period occurring less often. Many women have abnormal bleeding between their periods at some point in their lives. Abnormal bleeding occurs when you have:Heavier bleeding than usual Bleeding for more days than normal (menorrhagia) Spotting or bleeding between periods Bleeding after sex Bleeding after menopause Bleeding while pregnant Bleeding before age 9 Menstrual cycles longer than 35 days or shorter than 21 days No period for 3 to 6 months (amenorrhea) Causes There are many causes of abnormal vaginal bleeding.HORMONESAbnormal bleeding is often linked to failure of regular ovulation (anovulation). Doctors call the problem abnormal uterine bleeding (AUB) or anovulatory uterine bleeding. AUB is more common in teenagers and in women who are approaching menopause.Abnormal uterine bleeding (AUB)Abnormal uterine bleeding (AUB) is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Bleeding may be heavier o...Read Article Now Book Mark Article Women who take oral contraceptives may experience episodes of abnormal vaginal bleeding. Often this is called "breakthrough bleeding." This problem often goes away on its own. However, talk to your health care provider if you have concerns about the bleeding.PREGNANCYPregnancy complications such as:Ectopic pregnancy Ectopic pregnancyAn ectopic pregnancy is a pregnancy that occurs outside the womb (uterus).Read Article Now Book Mark Article Miscarriage MiscarriageA miscarriage is the spontaneous loss of a fetus before the 20th week of pregnancy. Pregnancy losses after the 20th week are called stillbirths. Mi...Read Article Now Book Mark Article Threatened miscarriageThreatened miscarriageA threatened miscarriage is a condition that indicates the potential for a miscarriage or early pregnancy loss. It might take place before the 20th ...Read Article Now Book Mark Article PROBLEMS WITH REPRODUCTIVE ORGANSProblems with reproductive organs may include:Infection in the uterus (pelvic inflammatory disease) Recent injury or surgery to the uterus Noncancerous growths in the womb, including uterine fibroids, uterine or cervical polyps, and adenomyosis Inflammation or infection of the cervix (cervicitis) Injury or disease of the vaginal opening (caused by intercourse, infection, polyp, genital warts, ulcer, or varicose veins) Endometrial hyperplasia (thickening or build-up of the lining of the uterus)MEDICAL CONDITIONSProblems with medical conditions may include:Polycystic ovary syndrome Cancer or precancer of the cervix, uterus, ovary, or fallopian tube Thyroid or pituitary disorders Diabetes Cirrhosis of the liver Lupus erythematosus Bleeding disordersOTHER CAUSESOther causes may include:Use of an intrauterine device (IUD) for birth control (may cause spotting) Cervical or endometrial biopsy or other procedures Changes in exercise routine Diet changes Recent weight loss or gain Stress Use of certain drugs such as blood thinners (Warfarin or Coumadin) Sexual abuse An object in the vagina Effect of low estrogen levels on the vaginal tissue Symptoms Symptoms of abnormal vaginal bleeding include:Bleeding or spotting between periods Bleeding after sex Bleeding more heavily (passing large clots, needing to change protection during the night, soaking through a sanitary pad or tampon every hour for 2 to 3 hours in a row) Bleeding for more days than normal or for more than 7 days Menstrual cycle less than 28 days (more common) or more than 35 days apart Bleeding after you have gone through menopause Heavy bleeding associated with anemia (low blood count, low iron)AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...Read Article Now Book Mark Article Bleeding from the rectum or blood in the urine may be mistaken for vaginal bleeding. To know for certain, insert a tampon into the vagina and check for bleeding.Keep a record of your symptoms and bring these notes to your doctor. Your record should include:When menstruation begins and ends How much flow you have (count numbers of pads and tampons used, noting whether they are soaked) Bleeding between periods and after sex Any other symptoms you have Exams and Tests Your provider will perform a physical exam, including a pelvic exam. Your provider will ask questions about your medical history and symptoms.You may have certain tests, including:Pap/HPV test Urinalysis Thyroid functioning tests Complete blood count (CBC) Iron count Pregnancy testBased on your symptoms, other tests may be needed. Some can be done in your provider's office. Others may be done at a hospital or surgical center:Sonohysterography: Fluid is placed in the uterus through a thin tube, while vaginal ultrasound images are made of the uterus. Ultrasound: Sound waves are used to make a picture of the pelvic organs. The ultrasound may be performed abdominally or vaginally. Magnetic resonance imaging (MRI): In this imaging test, powerful magnets are used to create images of internal organs. Hysteroscopy: A thin telescope-like device is inserted through the vagina and the opening of the cervix. It lets the provider view the inside of the uterus. HysteroscopyHysteroscopy is a procedure to look at the inside of the womb (uterus). Your health care provider can look at the:Opening to the womb (cervix)Inside...Read Article Now Book Mark Article Endometrial biopsy: Using a small or thin catheter (tube), tissue is taken from the lining of the uterus (endometrium). It is looked at under a microscope. Treatment Treatment depends on the specific cause of the vaginal bleeding, including: Hormonal changes Endometriosis EndometriosisEndometriosis occurs when cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy bleeding, bleedin...Read Article Now Book Mark Article Uterine fibroids Uterine fibroidsUterine fibroids are tumors that grow in a woman's womb (uterus). These growths are typically not cancerous (benign).Read Article Now Book Mark Article Ectopic pregnancy Ectopic pregnancyAn ectopic pregnancy is a pregnancy that occurs outside the womb (uterus).Read Article Now Book Mark Article Polycystic ovary syndromePolycystic ovary syndromePolycystic ovary syndrome (PCOS) is a condition in which a woman has increased levels of male hormones (androgens). Many problems occur as a result ...Read Article Now Book Mark Article Treatment may include hormonal medicines, pain relievers, and possibly surgery.The type of hormone you take will depend on whether you want to get pregnant as well as your age.Birth control pills can help make your periods more regular. Hormones also can be given as an injection, a skin patch, a vaginal cream, or through an IUD that releases hormones. An IUD is a birth control device that is inserted in the uterus. The hormones in the IUD are released slowly and may control abnormal bleeding.Other medicines given for AUB may include:Nonsteroidal anti-inflammatory drugs (ibuprofen or naproxen) to help control bleeding and reduce menstrual cramps Tranexamic acid to help treat heavy menstrual bleeding Antibiotics to treat infectionsProcedures for AUB may include:Endometrial ablation Endometrial ablationEndometrial ablation is a surgery or procedure done to disrupt the lining of the uterus in order to minimize heavy or prolonged menstrual flow. This...Read Article Now Book Mark Article Surgical removal of benign growths Procedures to block blood supply to uterine vessels HysterectomyHysterectomyHysterectomy is surgery to remove a woman's womb (uterus). The uterus is a hollow muscular organ that nourishes the developing baby during pregnancy...Read Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if:You have soaked through a pad or tampon every hour for 2 to 3 hours. Your bleeding lasts longer than 1 week. You have vaginal bleeding and you are pregnant or could be pregnant. You have severe pain, especially if you also have pain when not menstruating. Your periods have been heavy or prolonged for three or more cycles, compared to what is normal for you. You have bleeding or spotting after reaching menopause. You have bleeding or spotting between periods or caused by having sex. Abnormal bleeding returns. Bleeding increases or becomes severe enough to cause weakness or lightheadedness. You have fever or pain in the lower abdomen Your symptoms become more severe or frequent. Prevention Aspirin may prolong bleeding and should be avoided if you have bleeding problems. Ibuprofen most often works better than aspirin for relieving menstrual cramps. It also may reduce the amount of blood you lose during a period.Open ReferencesReferencesACOG Practice Bulletin No. 110: noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010;115(1):206-218. PMID: 20027071 pubmed.ncbi.nlm.nih.gov/20027071/.American College of Obstetricians and Gynecologists. ACOG Committee Opinion No 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013;121(4):891-896. PMID: 23635706 pubmed.ncbi.nlm.nih.gov/23635706/.Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.Ryntz T, Lobo RA. Abnormal uterine bleeding: etiology and management of acute and chronic excessive bleeding. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 26.Seller RH, Symons AB. Menstrual irregularities. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 20.AllVideoImagesTogSelf Care Living with uterine fibroidsVaginal bleeding in late pregnancy Tests for Vaginal or uterine bleeding Transvaginal ultrasoundRelated Information Review Date: 12/2/2020 Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. 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