Vaginal bleeding outside of a typical menstrual period, known as abnormal vaginal bleeding, can be concerning and may signal various health conditions.

While menstrual bleeding is a natural part of the reproductive cycle, bleeding at unexpected times or in unusual amounts can be distressing and warrants medical attention.

Wondering what are causes of vaginal bleeding? Want to learn more about its symptoms and available treatment?

In this blog, Karetrip will discuss the symptoms, causes, and treatment options for vaginal bleeding, as well as critical considerations for recognizing when to seek medical help.

Symptoms of Abnormal Vaginal Bleeding

Abnormal vaginal bleeding can vary in presentation, depending on the underlying cause. Common symptoms include

• Bleeding outside of a regular menstrual period: Spotting or bleeding at unexpected times in the menstrual cycle is a key sign.

• Heavy menstrual bleeding (menorrhagia): Excessive bleeding during regular periods can indicate an abnormality, especially if it disrupts daily activities.

• Irregular menstrual cycles: Variability in cycle length, flow amount, or other aspects of the menstrual period can be symptomatic of hormonal imbalances or other issues.

• Postmenopausal bleeding: Any bleeding after menopause is considered abnormal and should be investigated, as it may be linked to serious health conditions.

• Pain or cramping: Abnormal bleeding is sometimes accompanied by pelvic pain or cramps, which can suggest underlying health issues like fibroids or infections.

Causes of Vaginal Bleeding

Abnormal vaginal bleeding can arise from several sources, ranging from benign to more serious causes. Here are some of the most common causes

• Hormonal Imbalance

  Hormonal imbalances are among the most common reasons for abnormal bleeding. Oestrogen and progesterone are the primary hormones that regulate the menstrual cycle, and an imbalance can lead to irregular bleeding.

Hormonal fluctuations can result from stress, lifestyle changes, sudden weight gain or loss, and conditions like polycystic ovary syndrome (PCOS). Hormonal birth control methods, such as oral contraceptives or hormone releasing IUDs, can also alter bleeding patterns, particularly when first introduced or if taken inconsistently.

• Polycystic Ovary Syndrome (PCOS)

  PCOS is a hormonal disorder that affects many women of reproductive age and is a leading cause of abnormal bleeding. Women with PCOS may experience irregular menstrual cycles, spotting, or prolonged heavy bleeding.

The disorder is marked by an overproduction of androgens, which disrupts ovulation and can lead to the formation of small cysts in the ovaries, contributing to irregular bleeding and other symptoms.

• Pregnancy Complications

  Bleeding during pregnancy can indicate several conditions, some of which require immediate medical attention. In early pregnancy, spotting may occur as a result of implantation bleeding, which is typically harmless.

However, bleeding could also indicate an ectopic pregnancy (when a fertilised egg implants outside the uterus) or a miscarriage, both of which are medical emergencies. In later stages of pregnancy, bleeding can indicate conditions like placental abruption or placenta previa, which also require prompt medical intervention.

• Uterine Fibroids and Polyps

  Uterine fibroids are benign growths that develop within the uterine wall, while polyps are small, usually noncancerous growths that occur on the inner wall of the uterus.

Both fibroids and polyps can cause heavy, irregular bleeding, painful periods, and discomfort in the pelvic area. Fibroids are more common in women of reproductive age and are linked to factors like age, family history, and hormonal levels.

• Endometriosis

  Endometriosis is a painful disorder where tissue similar to the uterine lining grows outside the uterus, often on the ovaries, fallopian tubes, or intestines. This condition can lead to abnormal bleeding, heavy periods, severe cramps, and pain during intercourse.

Endometriosis can also cause irregular bleeding due to the displaced tissue’s response to hormonal fluctuations, even though it cannot shed like normal uterine tissue.

• Pelvic Inflammatory Disease (PID)

  PID is an infection of the female reproductive organs caused by sexually transmitted bacteria, often as a result of untreated sexually transmitted infections (STIs) like chlamydia or gonorrhoea.

PID can cause irregular bleeding, pain in the lower abdomen, and unusual vaginal discharge. It is a serious condition that can result in infertility if left untreated.

• Cancer

  In rare cases, abnormal bleeding may be a symptom of cancer, such as cervical, uterine, or ovarian cancer. Postmenopausal bleeding is a potential indicator of uterine cancer and should never be ignored.

Women with abnormal bleeding, particularly those at higher risk for reproductive cancers, should undergo medical evaluation to rule out malignancy.

• Medications

  Certain medications, particularly anticoagulants (blood thinners) or hormonal therapies, can cause unexpected bleeding. In some cases, high doses of NSAIDs (nonsteroidal antiinflammatory drugs) can also contribute to abnormal menstrual bleeding.

Treatment Options for Vaginal Bleeding

Treatment for abnormal vaginal bleeding depends on the underlying cause, age, and individual health factors. Below are some of the common treatment options

• Hormonal Therapy

  Hormonal medications, including oral contraceptives, progesterone, or oestrogen therapy, are often used to regulate the menstrual cycle and control bleeding.

These treatments are effective for managing bleeding caused by hormonal imbalances, PCOS, or uterine fibroids. In postmenopausal women, low dose hormonal therapy may be considered to manage bleeding and other symptoms.

• Nonsteroidal AntiInflammatory Drugs (NSAIDs)

  NSAIDs, such as ibuprofen, can be used to reduce heavy bleeding and alleviate menstrual pain. By inhibiting prostaglandin production, these medications can help reduce blood flow during menstruation. However, they are not a long term solution for underlying issues like fibroids or endometriosis.

• Antibiotics

  When abnormal bleeding is caused by an infection, such as PID, antibiotics are prescribed to clear the infection. Completing the full course of antibiotics as prescribed is essential to prevent complications like scarring or infertility.

• Surgical Procedures

  1. Dilation and Curettage (D&C): A D&C procedure involves scraping or suctioning the uterine lining to remove polyps or excess tissue, which can reduce heavy bleeding. It is sometimes used for diagnostic purposes to examine the uterine lining.

  2. Hysteroscopy: This minimally invasive procedure involves inserting a thin scope into the uterus to examine and remove polyps or small fibroids that may be causing bleeding.

  3. Endometrial Ablation: This procedure destroys the lining of the uterus, which reduces or stops heavy bleeding. It is generally recommended for women who do not wish to have children in the future.

  4. Hysterectomy: In cases where other treatments are ineffective, a hysterectomy (removal of the uterus) may be recommended to address chronic bleeding issues, fibroids, or endometrial cancer.

• Management of Underlying Conditions

  If bleeding is caused by conditions such as endometriosis or cancer, treatment may involve a combination of surgery, hormone therapy, and other specialised care. For example, women with endometriosis may benefit from hormone therapy to reduce the growth of endometrial tissue.

• Lifestyle Changes and Monitoring

  Lifestyle modifications, including maintaining a healthy weight, managing stress, and avoiding excessive caffeine and alcohol, can contribute to more stable hormone levels. Regular monitoring of menstrual patterns, either through tracking apps or journals, can also help detect early signs of irregular bleeding patterns.

When to See a Doctor

Abnormal vaginal bleeding should never be ignored, especially if it is accompanied by other symptoms such as

• Severe pain or cramping

• Unusual vaginal discharge

• Dizziness or fainting

• Bleeding after menopause

• Heavy bleeding that soaks through a pad or tampon every hour for several hours

Seeking prompt medical attention can ensure that the cause is properly identified and treated to avoid complications.

The information provided represents the views and opinions of Karetrip. It is crucial to conduct your own independent research before making any decisions regarding your healthcare journey.