Vaginal bleeding is any bleeding from your vaginal area. It can refer to bleeding related to menstruation or bleeding unrelated to menstruation such as from trauma or a medical condition. In most cases, vaginal bleeding refers to bleeding that’s not related to menstruation (your period).
Bleeding between periods or bleeding outside of a normal menstrual cycle is abnormal (irregular) vaginal bleeding. This type of bleeding can be random, impossible to predict and may be accompanied by pain or other symptoms. Vaginal bleeding not caused by menstruation can be caused by many factors like:
- Health or medical conditions.
- Medications.
- Pregnancy.
- Hormones.
- Menopause.
- Injury or trauma.
- Infection.
You may experience spotting or vaginal bleeding at some point in your life. Usually, it’s not a cause for worry. However, you should be evaluated by a healthcare provider to be sure. In some cases, vaginal bleeding is a sign of a serious condition.
Causes of vaginal bleeding
There are many causes of vaginal bleeding other than menstruation. You should always work with a healthcare provider to determine the cause of your bleeding. Some of the more common causes are medical conditions, hormones and pregnancy complications.
Medical conditions
- Cancers of the female reproductive system: These can include cancers of your cervix, endometrium (lining of your uterus), ovaries or fallopian tubes.
- Bleeding disorders: A problem with normal blood clotting can result from an inherited condition such as hemophilia or von Willebrand Disease, a low red blood cell count (thrombocytopenia), a deficiency of Vitamin K (which helps the body make blood-clotting factors) or as a side effect of medications (such as blood thinners).
- Hypothyroidism: An underactive thyroid gland can interrupt normal menstrual cycles.
- Uterine fibroids: Non-cancerous growths that develop from the muscle tissue of your uterus. Their size, number, growth rate and location within your uterus can vary greatly.
- Adenomyosis: A condition where the lining of your uterus grows through the uterine wall.
- Uterine (endometrial) polyps: An overgrowth of cells on the lining of your uterus. Polyps are usually not cancerous, but some can develop into precancerous polyps.
- Severe cervicitis: Cervicitis is inflammation or infection of your cervix.
- Endometrial hyperplasia: The endometrium becomes too thick, usually due to a hormonal imbalance of estrogen and progesterone. This condition isn’t cancerous, but in some cases can lead to cancer of your uterus.
Hormones
- Anovulation: A disruption or failure of your ovaries can be due to a disorder of your ovaries themselves or from a problem in how the brain is signaling the glands that control ovulation.
- Hormonal birth control pills: Some people experience breakthrough bleeding while taking oral contraceptives. The problem tends to resolve on its own.
- Polycystic ovary syndrome: A type of hormonal imbalance that causes irregular periods, weight gain, acne and excess hair growth.
Pregnancy complications
- Ectopic pregnancy: A pregnancy in which a fertilized egg grows outside your uterus, usually in your fallopian tubes.
- Placental abruption: Detachment of the placenta (the sac that contains a fetus) from the wall of your uterus.
- Placenta previa: When the placenta lies low in your uterus and partly or completely covers your cervix (the opening to your uterus).
- Preterm labor: Labor that occurs before the 37th week of pregnancy.
- Miscarriage: Loss of pregnancy before the 20th week.
Other possible causes
- Birth control devices: Using birth control devices such as the intrauterine device (IUD) can cause spotting.
- Hormone replacement therapy: A treatment used to relieve symptoms of menopause.
- Infection: This can occur in the pelvic cavity or urinary tract. It can also include bleeding caused by sexually transmitted infections (STIs).
- Injury: Injury to or a foreign object in your vagina.
- Cervical or endometrial biopsy: A biopsy is a procedure where tissue is removed from your cervix or uterus and examined for problems.
Diagnosis
Gynaecology Doctors at Shreya Hospital in Ghaziabad will ask you questions about your symptoms and health history. They’ll perform a physical exam and pelvic exam. You can expect your provider to ask some of the following questions:
- When did the bleeding start?
- When does it occur in relation to your period?
- Do you bleed during sex?
- How many pads are you soaking per day?
- How long does your menstrual period last?
- How long between each menstrual cycle?
- What medications are you taking?
- Have you had any recent procedures or surgeries?
- Is there a chance you’re pregnant?
Gynaecologist may order the following tests to help them find the cause of your vaginal bleeding:
- Pap test.
- Urinalysis.
- Thyroid functioning tests.
- Complete blood count (CBC).
- Pregnancy test.
- Ultrasound.
- Magnetic resonance imaging (MRI).
- Hysteroscopy.
Treatment
Treatment for vaginal bleeding depends on the cause of the bleeding, your age and if you wish to become pregnant. If a hormonal imbalance is the cause, your provider may recommend lifestyle changes such as eating a healthy diet, reducing stress and losing weight. Other times, medication or surgery is needed to treat vaginal bleeding.
Medications for vaginal bleeding
- Hormonal birth control methods (pills, patch or vaginal ring): These forms of birth control may reduce menstrual flow and help periods become more regular.
- Intrauterine device (IUD): Certain types of IUDs can be used for both birth control and to minimize or stop bleeding.
- Gonadotropin-releasing agonists (medications that reduce the release of gonadotropin, a hormone that stimulates your ovaries): Used to stop menstrual flow and reduce the size of fibroids.
- Tranexamic acid: Used to stop excessive menstrual bleeding.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen: Can help control heavy bleeding.
- Antibiotics: Used when bleeding is caused by an infection.
Surgical treatment for vaginal bleeding
- Endometrial ablation: Destroys the lining of your uterus, which reduces or stops the bleeding. Discuss this procedure with your provider if you want to become pregnant in the future.
- Dilation and curettage (D&C): Scraping away or suctioning tissue from your uterus.
- Uterine artery embolization: Used to treat fibroids by blocking blood vessels in your uterus that fibroids use to grow.
- Myomectomy: Removes fibroids but not your uterus.
- Hysterectomy: Removal of your uterus. It may be used when other treatments have failed or to treat endometrial cancer.
- Surgical removal of benign (non-cancerous) growths.