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Abnormal Vaginal Bleeding

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Definition

Any vaginal bleeding that occurs at a time in life when you are not expecting it, such as before age 10, during pregnancy or after menopause. Vaginal bleeding can also be considered abnormal when the flow of blood during menstrual period is lighter or heavier than what is normal for you, or there is vaginal bleeding or spotting between periods (inter-menstrual bleeding).

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Causes

  • Ectopic pregnancy
  • Miscarriage or abortion
  • Placenta previa.
  • Dysfunctional uterine bleeding - occurs between menstrual cycles in the absence of ovulation.
  • Abruptio placenta or early detachment of the placenta from the wall of the pregnant uterus.
  • Sometimes ovulation can cause mid cycle bleeding.
  • Peri-menopause if you are over 40 years of age.
  • Medications, such as birth control pills, anti-coagulants (blood thinners), taking aspirin or aspirin containing medications for medical conditions like arthritis.
  • An intrauterine contraceptive device (IUD)
  • Women who are breast-feeding
  • Sexually Transmitted Diseases
  • Injury to the vagina during rape, surgery, fall or blunt trauma on the abdomen and groin area.
  • Extreme emotional stress
  • Bleeding varicocele
  • Excessive exercise
  • Hormonal imbalances caused by other diseases, such as hyperthyroidism or diabetes
  • Uterine fibroids
  • Endometriosis
  • Infection of the pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries)
  • Urethral prolapse
  • Ovarian tumors
  • Ovarian polyps
  • Cervical polyps
  • Cervical cancer may cause bleeding after intercourse.
  • Bleeding during the first few weeks after delivery (postpartum) or after an abortion may be due to:
    • Fetal tissue remains in the uterus (retained products of conception).
    • The uterus has not contracted completely.
  • Being overweight or underweight can be a contributing factor for abnormal vaginal bleeding.

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Symptoms

  • Vaginal bleeding or spotting between periods
  • Abnormal menstrual periods, either heavy or scanty.
  • Variable duration of menstrual period ranging from 2-10 days
  • Variable menstrual cycle, usually less than 28 days between menstrual periods
  • Vaginal pain, tenderness and burning

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Implications

Vaginal bleeding may be a serious problem especially in post-menopausal women (women over 50 yrs. age) as the risk of malignancy increases with age. Insert a tampon into the vagina to confirm that bleeding is coming from the vagina, cervix or uterus and not from the rectum or the kidneys. The bleeding may be consistent, recurrent and can be severe enough to cause serious and life threatening complications like weakness, lightheadedness, anemia and arrhythmias. Abnormal vaginal bleeding may be associated with fever and pain in the lower abdomen develops.

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What You Can Do

  • Any abnormal bleeding occurring during pregnancy is a problem that needs immediate consultation, evaluation and treatment by the physician or Ob/Gyn specialist.
  • Stop doing what you are doing and rest.
  • Bed rest is indicated.
  • Oral antibiotics for sexually transmitted and non-sexual infections.
  • Over-the-counter pain killers like tylenol, ibuprofen (Advil, Motrin)
  • Avoid aspirin as it may prolong bleeding
  • Heat pad over the abdomen can provide some relief to pain.
  • Maintain a healthy weight.
  • Eat a nutritious and well balanced diet.
  • Drink lots of fluids.
  • Exercise regularly
  • Get plenty of rest and sleep.
  • Use oral contraceptives as directed by the physician. Take them every day and preferably at the same time of the day.
  • Take hormone replacement therapy as advised by your physician.
  • Practice relaxation exercises to cope with stress.
  • Take supplements like vitamin B complex, folic acid, iron, calcium, vitamin C and K.
  • Surgery may be indicated for:
    • Uterine fibroids
    • Endometriosis
    • Urethral prolapse
    • Ovarian tumors
    • Ovarian polyps
    • Cervical polyps
    • Cervical cancer

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Abnormal Vaginal Bleeding