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Abnormal Vaginal Bleeding

Abnormal vaginal bleeding occurs between menstrual periods, after sex, or after menopause. Menstrual periods that are heavier or last longer than usual or last more than seven days also are considered abnormal.

Your doctor will likely perform a physical and pelvic exam and may test your blood, hormone levels and thyroid function to determine if you are pregnant or infected with a sexually transmitted disease. Imaging tests such as pelvic ultrasound, transvaginal ultrasound, ultrasound of the uterus, pelvic MRI, hysteroscopy or endometrial biopsy also may be used to help diagnose your condition. Treatment depends on the underlying cause and may include medication, uterine fibroid emobolization, endometrial ablation or surgical intervention.

What is abnormal vaginal bleeding?

Normal vaginal bleeding, or menstruation (also called a period), is part of a woman's menstrual cycle. It typically occurs every 21 to 35 days and lasts from two to seven days. Abnormal vaginal bleeding is bleeding from the vagina that occurs:

  • between periods (including spotting)
  • after sex
  • during menstruation, but is heavier than usual or that lasts longer than usual, or more than seven days
  • after menopause.

Abnormal vaginal bleeding has various causes, including fibroids, endometrial polyps, an infection of the uterus, pregnancy, miscarriage, ectopic pregnancy, retained products of conception following pregnancy, or cancers of the uterus including endometrial and cervical cancers.

How is abnormal vaginal bleeding evaluated?

To determine the cause of abnormal bleeding, your physician will perform a physical exam, including a pelvic exam, and may perform one or more of the following:

How is abnormal vaginal bleeding treated?

Treatment for abnormal vaginal bleeding depends on the underlying cause, and may include:

  • medication
  • birth control pills or hormone-releasing intrauterine devices.
  • Uterine fibroid embolization (UFE). In this minimally invasive procedure guided by an x-ray camera called a fluoroscope, tiny particles are injected through a catheter into uterine arteries that are delivering blood to fibroids, blocking blood flow and causing the fibroids to shrink.
  • Endometrial ablation. Guided by a narrow lighted tube with a viewing device on the end (called a hysteroscope), the lining of the uterus is destroyed using a laser or other specialized instruments that produce heat, freezing, microwave energy or electrical currents.
  • Myomectomy, the surgical removal of fibroids.
  • Dilation and curettage (D&C). A procedure in which endometrial tissue is gently scraped or suctioned from the uterus.
  • Hysterectomy. A surgical procedure in which the uterus is removed.

This page was reviewed on February 11, 2020


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