Doctor's Notes on Abnormal Vaginal Bleeding
Vaginal bleeding is any bleeding from the vagina; typically, the term is used to refer to bleeding that is not a result of the normal menstrual cycle. Vaginal bleeding can have many causes, including hormonal disorders, benign or malignant tumors, blood clotting disorders, certain medications, and infections. In pregnant women, vaginal bleeding can be a sign of premature labor or other abnormalities, depending on the stage of the pregnancy.
Signs and symptoms associated with vaginal bleeding depend on the cause and may include:
- vaginal discharge,
- abdominal pain or fullness,
- pelvic pain,
- pain with sexual intercourse, or
- redness and itching of the genital area.
Other symptoms can include:
- vaginal pain,
- vaginal dryness,
- irregular menstrual periods, or
- excessively heavy menstrual bleeding.
What Is the Treatment for Abnormal Vaginal Bleeding?
Treatment for abnormal vaginal bleeding depends on the underlying cause and severity of the bleeding and may include:
- Anti-inflammatory or pain medications
- Antibiotics for infections
- Hormonal treatments such as birth control pills or hormone-releasing IUDs
- Endometrial ablation, which uses heat, cold, electricity, or a laser to destroy the lining of the uterus
- Myomectomy or uterine artery embolization to treat fibroids
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Bleeding During PregnancyBleeding during all phases of pregnancy may be dangerous, even though it can be caused by a large variety of factors. You should call your health care professional if you have any signs of vaginal bleeding during your pregnancy.
Ectopic PregnancyEctopic pregnancy is a condition in which a pregnancy develops inside of a Fallopian tube or outside of a woman's uterus. Causes and risk factors for ectopic pregnancy include previous Fallopian tube infections (pelvic inflammatory disease, Chlamydia, gonorrhea), previous surgery to the abdomen, use of fertility medications, prior tubal pregnancy, and use of an IUD. Symptoms of ectopic pregnancy include pelvic pain and vaginal bleeding. If you suspect you have an ectopic pregnancy, medical care should be sought urgently.
Endometrial CancerUterine (endometrial) cancer is the fourth most common cancer in women in the U.S. Read about staging, symptoms, prognosis, risk factors and treatment. Treatment may include radiation therapy, chemotherapy, and hormone therapy.
EndometriosisEndometriosis is a disease in which abnormal endometrial cells grow outside of the uterus and other organs commonly found in the pelvic area. Some women with endometriosis have no symptoms, but others with the disease may experience pelvic pain, pain during intercourse and during pelvic exams, cramping during sex, bowel movements, or while urinating. The four stages of endometriosis are minimal, mild, moderate, and severe. Medications and surgery are treatments for endometriosis. Endometriosis is a chronic condition and there is no cure.
Foreign Body, VaginaForeign objects in the vagina can include objects designed to use in a woman's vagina (for example, tampons, medications, vaginal suppositories) and objects not designed to insert into the vagina. Common symptoms of a foreign object in the vagina include unusual vaginal bleeding, vaginal itching, vaginal discharge, pain with urination, vulvar discomfort, abdominal pain, or pelvic pain. Treatment of objects in the vagina depend on the object, if it is embedded, or easily removed by the patient or health care professional.
MiscarriageA miscarriage (spontaneous abortion) is a pregnancy that spontaneously ends before the fetus can survive. There are classifications of miscarriage that include threatened, inevitable, incomplete, and complete miscarriage. There are a variety of causes of a miscarriage. Causes of miscarriage include defective genes of the fetus, chronic illness, including diabetes, severe high blood pressure, kidney disease, lupus, and underactive or overactive thyroid gland, acute infections, including Germany measles, CMV, and mycoplasma (walking pneumonia), diseases and abnormalities of the internal female organs, and other factors, including certain drugs like alcohol, tobacco, and cocaine. Symptoms and signs of a miscarriage are vaginal bleeding, abdominal pain, and cramping. If a woman thinks she may be having a miscarriage, she should seek medical care with her doctor or go to an emergency department.
Threatened MiscarriageA threatened miscarriage is any vaginal bleeding other than spotting during early pregnancy. There may be causes for a threatened miscarriage such as an abnormal fetus, chronic illness of the mother, acute infections, and other factors (alcohol, tobacco, illegal drugs).
Uterine FibroidsUterine fibroids are benign tumors (non-cancerous tumors) of a woman's uterus. The exact reason why some women develop uterine fibroids is not known. Obesity, nulliparity, and early menstruation are conditions associated with uterine fibroids. Some of the symptoms of uterine fibroids include irregular vaginal bleeding, constipation, lower abdominal pain, infertility, and more. Treatment of a uterine fibroid depends on the size and location of the fibroid.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.