Abnormal Vaginal Bleeding - Topic Overview

Many women experience abnormal vaginal bleeding or spotting between periods sometime in their lives. Vaginal bleeding is considered to be abnormal if it occurs:

When you are not expecting your menstrual period.
When your menstrual flow is lighter or heavier than what is normal for you.
At a time in life when it is not expected, such as before age 10, when you are pregnant, or after menopause.

Causes of abnormal bleeding

Abnormal vaginal bleeding has many possible causes. By itself, it does not necessarily indicate a serious condition.

Because bleeding can indicate a problem with pregnancy, possible pregnancy should always be considered in a woman of childbearing age.
- Spotting to minimal bleeding may be normal, but any bleeding during pregnancy needs to be evaluated by your doctor.
- Heavy vaginal bleeding or bleeding that occurs before 12 weeks may indicate a serious problem, including an ectopic pregnancy or miscarriage.
- Heavy vaginal bleeding or bleeding that occurs after 12 weeks also may indicate a serious problem, such as placenta previa.
Ovulation can cause midcycle bleeding.
Polycystic ovary syndrome (PCOS) is a hormone imbalance that interferes with normal ovulation which can cause abnormal bleeding.
Medicines, such as birth control pills, sometimes cause abnormal vaginal bleeding. You may have minor bleeding between periods during the first few months if you have recently started using birth control pills. You also may have bleeding if you do not take your pills at a regular time each day. For more information, see the topic Birth Control.
An intrauterine device (IUD) also may increase your chances of spotting or heavy periods. For more information on the IUD, see the topic Birth Control.
Infection of the pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause vaginal bleeding, especially after intercourse or douching. Sexually transmitted diseases (STDs) are often the cause of infections. For more information, see the topic Exposure to Sexually Transmitted Diseases.
Pelvic inflammatory disease (PID) causes inflammation or infection of the uterus, fallopian tubes, or ovaries which can cause abnormal bleeding.

Other, less common causes of abnormal vaginal bleeding that may be more serious include:

Sexual abuse.
An object in the vagina.
Uterine fibroids, which are a common cause of heavy periods. For more information, see the topic Uterine Fibroids.
Structural problems, such as urethral prolapse or polyps.
Cancer of the cervix, uterus, ovaries, or vagina.
Extreme emotional stress and excessive exercise. But excessive exercise more frequently causes an absence of menstruation (amenorrhea).
Other diseases, such as hyperthyroidism or diabetes.

Heavy bleeding during the first few weeks after delivery (postpartum) or after an abortion may occur because the uterus has not contracted to the prepregnancy size or because fetal tissue remains in the uterus (retained products of conception).

If you are age 40 or older, abnormal vaginal bleeding may mean that you are entering perimenopause. In a woman who has not had a menstrual period for 12 months, vaginal bleeding is always abnormal and should be discussed with your doctor.

Treatment of abnormal vaginal bleeding depends on the cause of the bleeding.

Review the Emergencies and Check Your Symptoms section of this topic to determine if and when you should see your health professional.

WebMD Medical Reference from Healthwise

Last Updated: July 11, 2007

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

Abnormal Vaginal Bleeding Topics

Bladder Control Problems?
Have a Life Less Interrupted

Important Safety Information | Prescribing Information

ENABLEX is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:

· having a strong need to go to the bathroom right away (also called "urgency")
· leaks or wetting accidents (also called "urinary incontinence")
· having to go to the bathroom too often (also called "urinary frequency")

IMPORTANT SAFETY INFORMATION

You should not take once-daily ENABLEX if you have certain types of stomach problems, glaucoma, or have trouble emptying your bladder. Side effects of ENBLEX include blurred vision, and more commonly dry mouth, constipation, indigestion, and abdominal pain. Use caution when doing certain activities until you know how ENBALEX affects you.

As You Journey through Menopause, Vivelle-Dot Is By Your Side

VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.

INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information for Vivelle-Dot.

Prescribing Information