Abnormal Vaginal Bleeding
Is abnormal vaginal bleeding a cause for alarm? Not necessarily so. Vaginal bleeding is normal when it occurs during the menstrual cycle, which is about every 21 to 35 days. In this case, vaginal bleeding occurs when the lining of the uterus is shed. The bleeding may be light or heavy and occurs for a period of a few days.
When Does Vaginal Bleeding Become Abnormal?
Abnormal vaginal bleeding is generally based on the time of the month when the bleeding takes place, as well as the amount of bleeding that occurs.
In premenopausal women, abnormal vaginal bleeding may be characterized by the following:
- Bleeding in between menstrual periods
- Excessive amount of bleeding during the menstrual period
- Menses lasting 7 days or longer
- Anemia due to bleeding
- Abnormal genital tract bleeding due to abnormal uterine tissue such as endometrial polyps, endometrial hyperplasia, infection, etc.
- Benign tumors of the uterus such as fibroids
- Uterine cancer
- Cervical cancer
- Obesity
- Polycystic Ovaries
Abnormal vaginal bleeding in premenopausal women may also occur when the woman has just given birth, when a miscarriage takes place, or when the pregnancy is ectopic. In addition, abnormal vaginal bleeding in pregnant women can occur when the placenta overlies the cervix either partially or completely, and when the placenta tears away from the uterine wall during an abruption.
For a woman undergoing menopause where she has not had the menstrual period for twelve consecutive months, abnormal vaginal bleeding might be a cause for concern. Causes of this condition among postmenopausal women may include the following:
- endometrial hyperplasia
- cervical or endometrial polyps
- endometrial cancer
- vaginitis
- unopposed estrogen
Evaluation of Abnormal Vaginal Bleeding
If you suspect that you have abnormal vaginal bleeding, then you should consult a doctor for further evaluation of your condition. However, you will need to provide the doctor specific information regarding your abnormal vaginal bleeding. In particular, you should be able to provide your menstrual history.
The following are some of your doctor’s considerations when evaluating the vaginal bleeding:
Pregnancy. Vaginal bleeding may occur very early in the pregnancy, that you may not even be aware of the pregnancy.
Bleeding pattern. This would include the amount, interval, and duration of the bleeding. Abnormal bleeding may be characterized by menstruation that occurs either over a very short or very long period of time. Another indication is when the menstruation occurs too rarely or too frequently, or when the bleeding is excessive or too minimal.
Ovulation. Signs of irregular ovulation include abnormally low levels of progesterone during the second half of the menstrual cycle; and long periods of bleeding that occurs irregularly after not having menstruated for some months. These symptoms are common among obese women and those who have polycystic ovarian syndrome.
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