Vaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different.
- Most women have cycles between 24 and 34 days apart. It usually lasts 4 to 7 days.
- Young girls may get their periods anywhere from 21 to 45 days or more apart.
- Women in their 40s will often notice their period occurring less often.
Many women have abnormal bleeding between their periods at some point in their lives. Abnormal bleeding occurs when you have:
- Heavier bleeding than usual
- Bleeding for more days than normal (menorrhagia)
- Spotting or bleeding between periods
- Bleeding after sex
- Bleeding after menopause
- Bleeding while pregnant
- Bleeding before age 9
- Menstrual cycles longer than 35 days or shorter than 21 days
- No period for 3 to 6 months (amenorrhea)
Alternative Names
Irregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding
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:
- Menopause or perimenopause
- Changes in birth control pills or hormone medicines
PREGNANCY
Pregnancy complications such as:
- Ectopic pregnancy
- Miscarriage
PROBLEMS WITH REPRODUCTIVE ORGANS
Problems with reproductive organs may include:
- Infection in the uterus (pelvic inflammatory disease)
- Recent injury or surgery to the uterus
- Noncancerous growths in the womb, including uterine fibroids, uterine of cervical polyps, and adenomyosis
- Inflammation or infection of the cervix (cervicitis)
- Injury or disease of the vaginal opening (caused by intercourse, infection, polyp, genital warts, ulcer, or varicose veins)
- Endometrial hyperplasia (thickening or build-up of the lining of the uterus)
MEDICAL CONDITIONS
Problems with medical conditions may include:
- Polycystic ovary syndrome
- Cancer or precancer of the cervix, uterus, or (very rarely) fallopian tube
- Thyroid or pituitary disorders
- Diabetes
- Cirrhosis of the liver
- Lupus erythematosus
- Bleeding disorders
OTHER CAUSES
Other causes may include:
- Use of an intrauterine device (IUD) for birth control (may cause spotting)
- Cervical or endometrial biopsy or other procedures
- Changes in exercise routine
- Diet changes
- Recent weight loss or gain
- Stress
- Use of certain drugs such as blood thinners (warfarin or Coumadin)
- Sexual abuse
- An object in the vagina.