Abnormal vaginal bleeding

Abnormal vaginal bleeding: Here is what you should know!

Abnormal uterine bleeding is any vaginal bleeding that occurs between a menstrual cycle and the other. The abnormal bleeding is also indicated by the name of intermenstrual bleeding, spotting, and breakthrough bleeding.

Causes of abnormal vaginal bleeding

When bleeding occurs between normal periods, there can be many different causes.

While some causes may be easy to treat, others can be consequences of a serious condition. If you notice heavy blood spots or bleeding before your period or after your period, it’s important to see your doctor to get tested and to consider different treatment options after making a diagnosis. The potential causes of bleeding between the menstrual cycle and another include:

  • abnormal growth of the uterus or cervix
  • stress
  • a change in hormone therapies
  • a miscarriage
  • vaginal dryness
  • a hormonal imbalance
  • cancer

The average menstrual cycle lasts 21 to 35 days. Normal vaginal bleeding, also known as a menstrual cycle, can last from a couple of days to a week. Any other type of bleeding outside this period is considered abnormal and can be caused by a variety of factors, listed above. Let’s quickly examine them one by one.

Abnormal vaginal bleeding is a blood flow that emerges from the vagina outside the menstrual period. Abnormal vaginal bleeding can be:

  • mild
  • abundant

Abnormal vaginal bleeding can be caused by hormonal problems or certain diseases of the female reproductive system.


Vaginal bleeding: when is it abnormal?

Vaginal bleeding is considered abnormal if it occurs:

  • during a period outside the regular menstrual cycle
  • if your menstrual flow is lighter or heavier than usual
  • in unexpected periods: before puberty, during pregnancy, after menopause

Abnormal vaginal bleeding may be caused by different conditions:

  • period of ovulation
  • hormonal imbalances ( polycystic ovary syndrome )
  • taking birth control pills
  • presence of intrauterine devices for birth control
  • infection of the pelvic organs
  • sexually transmitted diseases
  • inflammation of the uterus

There are also less common, but potentially more serious causes that can explain abnormal vaginal bleeding.

Among these the main ones are:

  • pathologies such as hyperthyroidism and diabetes
  • presence of tumor forms in the pelvic organs
  • situation of extreme mental and/or physical stress


Intermenstrual bleeding and hormonal imbalances

Estrogen and progesterone are the two hormones that regulate the cycle. The spotting Intermenstrual can be caused by abnormal values of these hormones. Problems with the ovaries, thyroid problems, taking or stopping the birth control pill can affect the hormonal balance.

It should be noted that when starting any type of hormonal contraceptive, abnormal bleeding is quite common during the first three months. These contraceptives include:

  • birth control pill
  • intrauterine device
  • contraceptive patch
  • contraceptive implant or injection

Any blood loss in menopause can also be caused by hormonal imbalances, particularly a lack of estrogen. These blood losses should be reported to the doctor immediately to evaluate the possible causes, including uterine fibroids or polyps.


Vaginal bleeding in pregnancy

During pregnancy, there may be vaginal bleeding, especially in the early or late periods.

The causes can be:

  • implantation of the embryo;
  • spontaneous abortions;
  • ectopic pregnancies ;
  • detachment of the placenta ;
  • gestational trophoblastic disease;
  • placental polyps;
  • placenta previa.


Risks of abnormal vaginal bleeding in pregnancy

Cases of abnormal vaginal bleeding can also mean problems during pregnancy.

While it is true that minimal leakage phenomena are to be considered normal, any spotting phenomenon during pregnancy must be carefully evaluated by medical personnel.

Heavy vaginal bleeding occurs in the first 12 Settimana and can cause serious problems such as an ectopic pregnancy or a miscarriage.

Heavy vaginal bleeding that occurs after 12 weeks, however, can cause obstetric emergencies such as placenta previa, a situation where the placenta is inserted in the low part of the uterus, thus risking breaking away suddenly during labor.

Heavy abnormal vaginal bleeding can also occur after delivery or after an abortion.

This is because the uterus has not reached the appropriate size for the pregnancy, or because some fetal tissue has remained inside the uterus itself.

On the other hand, when abnormal bleeding affects women over the age of 40, it is possible that it is an indication of entering the perimenopause phase.

In general, in a woman without menstrual periods for 12 months, vaginal bleeding (of any extent) is always considered abnormal and should be brought to a doctor’s attention.


Vaginal bleeding and uterine fibroids

The uterine fibroids are cancerous growths that form in the uterus. They are not uncommon in women who have given birth. Their presence can cause blood loss between one menstrual cycle and another.


Abnormal vaginal bleeding and infections

Vaginal bleeding between periods can indicate an infection of the reproductive organs. The ongoing infection can in fact cause inflammation and bleeding. The main causes include:

  • sexually transmitted infections;
  • vaginal douches;
  • sexual intercourse
  • pelvic inflammatory disease, which is characterized by inflammation of the reproductive organs leading to scarring.

Bleeding after intercourse, for example, can also be caused by inflammation or vaginal dryness.

Traces of blood inside the vaginal discharge can be a symptom of genital infections. The color of the discharge can often help identify the type of infection or inflammation.

  • Transparent leaks: These types of slightly filamentous leaks are considered physiological leaks and are never combined with burning or itching.
  • Yellow discharge: yellow discharge before your period, or during pregnancy, may indicate the presence of sexually transmitted cervicitis or vulvovaginitis; sometimes yellowish losses are instead due to a yeast infection.
  • White discharge: Foamy, foamy, grayish or white discharge is often a sign of bacterial vaginosis (especially if it occurs after intercourse or intimate hygiene).
  • Thick white leaks: milky and “creamy” leaks are the classic symptom of Candida albincans infection.
  • Greenish discharges: This type of yellow-green discharge is a symptom of trichomoniasis, especially if associated with irritation or intense itching



When to seek medical attention for abnormal vaginal bleeding

When seeing your doctor about abnormal bleeding between periods, be prepared to answer questions about your symptoms.

To provide more accurate information it can be helpful to keep track of the cycle. It is therefore a good idea to take note of when the period begins and when it ends, the heaviness and duration of the flow, and when and how much intermenstrual bleeding occurs.

Your doctor may also ask about any other symptoms you have and about any medications you are taking.

Your doctor will likely also do a physical exam and may request a pelvic exam.

Diagnostic tests can help the specialist pinpoint the cause of the bleeding. Your doctor may order a blood test to check hormone levels. A biopsy, which is an examination of the tissue removed from the cervix or lining of the uterus, may be required. The doctor may also request an ultrasound.

Ultrasound is a diagnostic technique that uses sound waves to create an image of the reproductive organs.


Risks of intermenstrual bleeding

In some cases, this type of abnormal bleeding clears up on its own. However, for some women, the underlying cause requires treatment.

Ignoring the problem and avoiding a medical checkup can cause the problem to get worse.

If the cause of the bleeding is an infection, cancer, or another serious ailment, the consequences could be life-threatening.


Preventing abnormal vaginal bleeding

The ability to prevent intermenstrual vaginal bleeding depends on the underlying cause. However, in some cases, there are preventative measures that can help.

It is important, for example, to maintain a healthy lifestyle and a normal weight, because being overweight can lead to abnormal menstrual cycles.

If you take the birth control pill, it is good to do so following the directions to avoid hormonal imbalance. It is also advisable to practice moderate exercise, to maintain health and reduce stress.

To manage pain, ibuprofen or naproxen can be used, which can actually help reduce bleeding. It is recommended that you avoid taking aspirin, which can increase the risk of bleeding.


Treatment for abnormal vaginal bleeding

In cases of spotting, the recommended treatments largely depend on what is causing the bleeding.

WATCH VIDEO: More information about abnormal vaginal bleeding


If this concerns previous diseases or disorders, the disease must be kept under control.

If, on the other hand, they are the result of hormonal imbalances, fertility treatments, or birth control treatments, it is good to contact a gynecologist to agree on the best treatment to follow.

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