Abnormal Vaginal Bleeding

Many women experience abnormal vaginal bleeding or spotting between periods sometime in their lives. Vaginal bleeding is considered to be Reference abnormal if it occurs:

• When you are not expecting your menstrual period.
• When your menstrual flow is lighter or heavier than what is normal for you.
• At a time in life when it is not expected, such as before age 9, when you are pregnant, or after Reference menopause Opens New Window.

Causes of abnormal bleeding

Reference Abnormal vaginal bleeding has many possible causes. By itself, it does not necessarily indicate a serious condition.

• Because bleeding can mean a problem with pregnancy, possible pregnancy should always be considered in a woman of childbearing age.
  • Spotting to minimal bleeding may be normal, but any bleeding during pregnancy needs to be evaluated by your doctor.
  • Heavy vaginal bleeding or bleeding that occurs before 12 weeks may mean a serious problem, including an Reference ectopic pregnancy Opens New Window or Reference miscarriage Opens New Window.
  • Heavy vaginal bleeding or bleeding that occurs after 12 weeks also may mean a serious problem, such as Reference placenta previa Opens New Window.
• Reference Ovulation Opens New Window can cause Reference mid-cycle Opens New Window bleeding.
• Reference Polycystic ovary syndrome (PCOS) Opens New Window is a hormone imbalance that interferes with normal ovulation which can cause abnormal bleeding.
• Reference Medicines, such as birth control pills, sometimes cause abnormal vaginal bleeding. You may have minor bleeding between periods during the first few months if you have recently started using birth control pills. You also may have bleeding if you do not take your pills at a regular time each day. For more information, see the topic Reference Birth Control.
• An Reference intrauterine device (IUD) Opens New Window also may increase your chances of spotting or heavy periods. For more information on the IUD, see the topic Reference Birth Control.
• Infection of the Reference pelvic organs Opens New Window Reference Opens New Window (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause vaginal bleeding, especially after intercourse or douching. Sexually transmitted infections (STIs) are often the cause of infections. For more information, see the topic Reference Exposure to Sexually Transmitted Infections.
• Reference Pelvic inflammatory disease (PID) Opens New Window causes inflammation or infection of the uterus, fallopian tubes, or ovaries, which can cause abnormal bleeding.

Other less common causes of abnormal vaginal bleeding that may be more serious include:

• Reference Sexual abuse.
• An object in the vagina.
• Reference Uterine fibroids Opens New Window, which are a common cause of heavy periods. For more information, see the topic Reference Uterine Fibroids.
• Structural problems, such as Reference urethral prolapse Opens New Window or Reference polyps Opens New Window.
• Cancer of the Reference cervix Opens New Window, Reference uterus Opens New Window, Reference ovaries Opens New Window, or Reference vagina Opens New Window.
• Extreme emotional stress and excessive exercise. But excessive exercise more frequently causes an absence of menstruation (amenorrhea).
• Other diseases, such as Reference hyperthyroidism Opens New Window or Reference diabetes Opens New Window.

Heavy bleeding during the first few weeks after delivery (postpartum) or after an abortion may occur because the uterus has not contracted to the prepregnancy size or because fetal tissue remains in the uterus (retained products of conception).

If you are age 40 or older, abnormal vaginal bleeding may mean that you are entering Reference perimenopause Opens New Window. In a woman who has not had a menstrual period for 12 months, vaginal bleeding is always abnormal and should be discussed with your doctor.

Treatment of abnormal vaginal bleeding depends on the cause of the bleeding.

Reference Check your symptoms to decide if and when you should see a doctor.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.