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Vaginal bleeding

Abnormal irregular unexpected vaginal bleeding can be a cause of concern. It can happen any time during women life – during puberty or reproductive period, during pregnancy or miscarriage, during perimenopause or menopause. Vaginal bleeding could appear during menstrual period or between periods or in the middle of menopause.

Intensive and long vaginal bleeding during menstrual period called “menorrhagia” which could be combines with abdominal pain. Irregular vaginal bleeding between periods called “metrorrhagia”. Frequent bleeding (fewer than 21 days apart) called “polymenorrhea”. Some women could experience bleeding both during periods and between – this condition called “menometrorrhagia”.

According to medical studies, vaginal bleeding occurs most commonly during “hormonal storms” – at the beginning and end of the reproductive period of life. About 20-22% cases occur during puberty in adolescent girls, and more than 50% occur in women after 45. It was noted that 90% cases of vaginal bleeding correlate with anovulatory not fertile menstrual cycles (cycles without normal ovulation).

Vaginal bleeding could occur frequently or rare (irregularly), it could last few days or weeks, it could be moderate or very heavy. All depends on causes, hormonal status and women health conditions.

Vaginal bleeding causes

  • Hormonal dysfunctions (mainly hyperestrogenia – not balanced increased levels of estrogen);
  • Uterine fibroids or polyps;
  • Complicated pregnancy, miscarriage or ectopic pregnancy;

    Hormonal contraception or hormonal treatments;

  • Perimenopause or menopause;
  • Thyroid dysfunctions;
  • Infections or inflammation in reproductive organs;
  • Some medications such as anticoagulants;
  • Hemophilia or other inherited bleeding disorders;
  • Trauma or injury during sexual contacts or medical procedures or accidents;
  • Cancer of reproductive organs – cervix, ovaries, uterus or vagina.

Vaginal bleeding diagnosis

Vaginal bleeding

Vaginal bleeding

Diagnostic tests could discover all possible causes vaginal irregular bleeding. Usually doctor select diagnostic tests based on the findings during the interview and pelvic examination.

Dysfunctional uterine bleeding is abnormal and correlated with hormonal changes (mainly with not balanced increased levels of estrogen). Most informative tests are pelvic examination, ultrasonography, hormonal tests and endometrial biopsy. Modern ultrasonography can discover abnormalities inside the uterus – abnormal endometrial grow, thickened uterine lining, polyps or fibroids. Hormonal tests check levels of all hormones which are involved in reproductive system functioning. Endometrial or cervical biopsy can identify cancerous cells or cancer development. If the biopsy detects abnormal cells, treatment can be complicated including high doses of progestins and sometimes hysterectomy (removal of uterus).

Endometrial cancer risks can be increased in following cases:

  • After 35-40 (especially during menopause),
  • During obesity,
  • In women with PCOS (Polycystic Ovarian Syndrome);
  • Diabetes sufferers,
  • In women with high blood pressure,
  • In cases of abnormal endometrial grow (hyperplasia, thickening, multiple polyps).

Vaginal bleeding treatment

Treatment strategy depends on several factors including age, intensiveness of bleeding, hormonal status and results of ultrasonography and histological tests of biopsy.

Bleeding can be controlled using drugs, which may be hormones or not (progestins, birth control pills, NSAIDs (Non-steroidal anti-inflammatory drugs), tranexamic acid).

Sometimes ordinary dilatation and curettage can be effective. In some cases myomectomy, polypectomy or even hysterectomy may be required.


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