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Vaginal or uterine bleeding - overview

Irregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding

Vaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different.

Many women have abnormal bleeding between their periods at some point in their lives. Abnormal bleeding occurs when you have:

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Causes

There are many causes of abnormal vaginal bleeding.

HORMONES

Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB). DUB is more common in teenagers or in women who are approaching menopause.

It is not always clear what causes hormone changes that lead to DUB. Hormone changes may be due to:

PREGNANCY

Pregnancy complications such as:

PROBLEMS WITH REPRODUCTIVE ORGANS

Problems with reproductive organs may include:

MEDICAL CONDITIONS

Problems with medical conditions may include:

OTHER CAUSES

Other causes may include:

Symptoms

Symptoms of abnormal vaginal bleeding include:

Bleeding from the rectum or blood in the urine may be mistaken for vaginal bleeding. To know for certain, insert a tampon into the vagina and check for bleeding.

Keep a record of your symptoms and bring these notes to your doctor. Your record should include:

Exams and Tests

Your doctor will perform a physical exam, including a pelvic exam. Your doctor will ask questions about your medical history and symptoms

You may have certain tests, including:

Based on your symptoms, other tests may be needed. Some can be done in your health care provider's office. Others may be done at a hospital or surgical center:

Treatment

Treatment depends on the specific cause of the vaginal bleeding, including:

Treatment may include hormonal medicines, pain relievers, and possibly surgery.

The type of hormone you take will depend on whether you want to get pregnant as well as your age.

Other medications given for abnormal uterine bleeding may include:

When to Contact a Medical Professional

Call your doctor if:

Prevention

Aspirin may prolong bleeding and should be avoided if you have bleeding problems. Ibuprofen is usually works better than aspirin for relieving menstrual cramps. It also may reduce the amount of blood you lose during a period.

References

ACOG Practice Bulletin No. 110: Noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010 Jan;115(1):206-18. PMID: 20027071 www.ncbi.nlm.nih.gov/pubmed/20027071.

Lobo RA. Abnormal Uterine Bleeding : Ovulatory and Anovulatory Dysfunctional Uterine Bleeding: Management of Acute and Chronic Excessive Bleeding. In: Lentz GM, Lobo RA, Gershenson GM, Katz VL, eds., Comprehensive Gynecology, 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 37.

Marjoribanks J, Proctor M, Farquhar C, Derks RS. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001751. PMID: 20091521 www.ncbi.nlm.nih.gov/pubmed/20091521.

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Review Date: 12/28/2014  

Reviewed By: Irina Burd, MD, PhD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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