What is Abnormal Bleeding?
Abnormal bleeding covers a wide range of conditions but can usually be described as any vaginal bleeding that occurs when it is not expected or a sudden change to your normal menstrual cycle. It can include any one of the following:
- A menstrual cycle that is shorter than 21 days or longer than 40 days
- Bleeding that happens in between your cycle
- A period that is extremely heavy or painful
- Any bleeding that occurs after you have gone through menopause
- Bleeding or spotting after sex
Every woman is different so what is considered ‘normal’ for one woman is not necessarily ‘normal’ for another. The key is to keep an eye on anything that appears to be out of the ordinary for you.
Causes of Abnormal Vaginal Bleeding
The most common causes of abnormal bleeding include [1]:
- Ovulation – Changes in your ovulation can sometimes cause mid-cycle bleeding
- Polycystic ovary syndrome (PCOS) – PCOS is a hormone imbalance that interferes with normal ovulation and may sometimes cause vaginal bleeding
- Problems linked to some birth control methods, such as an intrauterine device (IUD) or birth control pills
- Infections – Infections of the pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause vaginal bleeding.
- Pelvic inflammatory disease (PID) -Inflammation or infection of the uterus, fallopian tubes
- Other causes: Uterine fibroids, cancer of the cervix or uterus or sexually transmitted infections
Symptoms Associated with Abnormal Vaginal Bleeding
Depending on the cause, abnormal bleeding may not be accompanied by any other symptoms. However from time to time some women may experience one or more of the following [1]:
- Stomach or pelvic pain
- Vaginal itching or abnormal discharge
- Fever
When to See a Doctor
Abnormal vaginal bleeding should always be investigated by a medical professional as soon as possible. Your doctor will be able to take a full medical history, carry out a physical examination and possibly order tests if required. By itself, abnormal vaginal bleeding does not necessarily indicate a serious condition but it should still be reported to your OBGYN as a matter of urgency.
Tests that May be Carried Out
Depending on your own medical history and examination some of the following tests may be ordered by your doctor:
- Blood tests -Your doctor may decide to do this to check your blood count and hormone levels. You may also have a pregnancy test and tests for sexually transmitted infections (STIs) if needed.
- Ultrasound exam – This is a non-invasive exam that allows doctors to get a physical picture of your pelvic organs. Other imaging tests that may be ordered include an MRI or CT-Scan.
- Other tests – In a small number of cases more advanced testing may be needed to find out the exact cause of the bleeding.
Treatment
The treatment of abnormal vaginal bleeding usually depends on the cause and the severity of your symptoms. For example in the case of heavy or painful menstrual cycles medications are usually tried in the first instance. A sexually transmitted infection or pelvic inflammatory disease would be treated with antibiotics.
Whatever the cause your doctor will be more than happy to sit down with you and discuss all suitable treatment options.
References
1) WebMD. Abnormal vaginal bleeding. William H. Blahd, Jr., MD, FACEP. November 14, 2014
https://www.webmd.com/women/tc/abnormal-vaginal-bleeding-topic-overview#1
