Abnormal Vaginal Bleeding

Abnormal vaginal bleeding is a general term that describes blood flow from the vagina that does not follow the normal pattern. It could be spotting between periods or heavier or lighter menstruation than what you would normally have.

Most women experience abnormal bleeding from the vagina at some point in their lives. Usually, there is nothing to worry about. 

But vaginal bleeding is deemed to be abnormal if it occurs:-

  • outside of your normal  menstrual cycle.
  • when your menstrual flow is lighter or heavier than what you normally experience.
  • after sexual intercourse.
  • at a time when there should not have blood coming from the vagina i.e. before a child reaches 10, when you are pregnant or after menopause.

 Causes of Vaginal Bleeding

Placenta Privia - Abnormal Vaginal BleedingDiagram of placenta previa

Pregnancy - Light vaginal spotting during pregnancy may be normal. for peace of mind and safety precaution do go for a medical checkup to rule out any complications.

Do be careful if you have heavy vaginal bleeding that occurs before the 12th week of pregnancy. This could be serious. There might be the possibility of an ectopic pregnancy or miscarriage.

And heavy bleeding that happens after the 20th week of gestation is not a good sign either. It could be placenta previa.

Placenta previa occurs when a baby’s placenta partially or totally covers the mother’s cervix. Placenta previa can cause severe bleeding before or during delivery. Refer to diagram above for a better idea of abnormal vaginal bleeding due to placenta previa.

Note :  The cervix is the doorway between the uterus and the vagina. (Please refer to the above diagram for a better understanding of placenta previa).

A note of caution: Do not take vaginal bleeding during pregnancy lightly. Contact your doctor immediately if you are pregnant and experience vaginal bleeding.

Ovulation - Ovulation refers to the release of a single, mature egg from the ovarian follicles. Bleeding may occur during the middle of a menstrual cycle (mid-cycle).

Ovulation bleeding tends to be pink or red in color.  It is lighter than a normal menstrual flow and generally last 1-2 days. Mid-cycle bleeding that last longer than a couple of days could be endometriosis.

Menstrual Cycles - Menstrual cycles that are longer than 35 days or shorter than 21 days. The lack of periods for 3-6 months (amenorrhea) is also abnormal.

Birth Control Methods - Abnormal vaginal bleeding may also be cause by birth control methods that contains hormones (pills, patches, shots, rings or implants). Doctors call this "break through bleeding". They believe bleeding occurs due to the extra hormones that cause changes in the lining of the uterus.

And this happens during the first three months after starting on the pill. Abnormal bleeding may also occur when the pill is not taken at a regular time each day.

Pelvic Inflammatory Disease - Pelvic inflammatory disease (PID) is an inflammation or infection of the uterus, fallopian tubes and ovaries.  Abnormal vaginal bleeding is one of the common PID symptoms. Other symptoms of PID are lower abdominal pain, fever and smelly vaginal white discharge.

Sexually Transmitted Infections - STIs such as gonorrhea and Chlamydia can cause abnormal vaginal bleeding between periods. 

Vaginal bleeding after sexual intercourse could be symptom of genital/vaginal warts

Menopause - After menopause, there is a drop in estrogen levels. As a result the vaginal walls become thinner and drier. Friction during intercourse tears the fragile vagina walls causing abnormal bleeding.

If menopausal vaginal dryness is the cause of bleeding after sex, applying a vaginal lubrication gel will help. It reliefs painful intercourse. Sex can still be very pleasurable after menopause.

Peri menopause, which starts around age 40 is also linked to abnormal uterine bleeding. As you get closer to menopause it is hard to predict your monthly period. Menstrual bleeding can be lighter or heavier than your pre -40 menstruation. As hormone levels change at this phase of your life, the lining of the uterus becomes thicker, so there could be spotting as well.

Do not ignore abnormal bleeding if you are menopausal and have not had your period for one whole year. It might be cancer related. Go for a pelvic examination for peace of mind. If it is detected early, you have a good chance of overcoming the disease.

Please go for a medical checkup promptly when  you have abnormal vaginal bleeding.

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