Published on January 12, 2022 at 13:21 / Updated on January 12, 2022 at 15:18

As soon as she enters puberty, a woman is subject to several physiological and hormonal changes. Periods are the main reason for vaginal bleeding; from the very first menstrual cycle to menopause.

However, a variety of conditions can influence the nature, frequency and amount of bleeding, sometimes causing abnormal vaginal bleeding.

While some heavy bleeding may be harmless, bleeding deemed abnormal is worth checking into.

Here you will find all the information relating to the definition, symptoms, causes and treatments of abnormal vaginal bleeding, and more.

What is abnormal uterine bleeding?

Uterine bleeding is said to be abnormal if it occurs outside a specific regularity, duration, and amount. Usually, abnormal uterine bleeding occurs at the beginning and end of a woman's childbearing years. According to statistics, 1 in 5 adolescent girls, as well as 1 in 2 women over the age of 45, will show signs of this at least once in their lifetime.

These vary in more than one way from woman to woman. Nevertheless, certain clinical signs are more frequently recorded. As we will see below, these signs help the doctor make an accurate diagnosis and prescribe adequate treatment, if necessary. It is therefore important to pay attention to the signs and symptoms of abnormal bleeding when they occur.

It is also important to remember that any vaginal bleeding that occurs between periods, before puberty, during pregnancy and after menopause is considered abnormal and requires consultation.

Signs and symptoms

Usually, vaginal bleeding occurs during your period. However, any bleeding during menstruation becomes abnormal if it:

  • A large amount of blood is being lost (saturation of 1 or 2 tampons or a regular pad per hour)
  • Occurs less than 21 days apart
  • Requires new protection overnight
  • Does not happen frequently enough, such as 90 days between the start of cycles
  • Lasts more than 7 days

Speaking to a healthcare professional about any doubts relating to abnormal vaginal bleeding is essential. An iron deficiency, fainting, and an impact on the quality of life may develop as a result of persistent abnormal bleeding.

These may or may not be accompanied by other symptoms, such as lower abdomen pain and fatigue. However, these symptoms have no direct relation to the severity of the bleeding.

Common causes of abnormal bleeding

The most common cause of abnormal uterine bleeding is hormonal in nature. In fact, ovulation can be delayed for several reasons. This delay causes estrogen levels to fluctuate (menorrhagia) and the endometrium continues to thicken, gorging its walls with blood. The more the tissue stores blood, the longer the elimination period (menstruation) will be.

Here are some other common causes of abnormal bleeding:

  • Bleeding during ovulation
  • Uterine fibroids or polyps: benign tumors more often seen after the age of 35
  • Taking oral contraceptives that can cause breakthrough bleeding (spotting)
  • Endometriosis

Less common causes

Rarer causes may explain this abnormal bleeding, such as:

  • Thyroid gland disorders
  • Coagulation disorders
  • An ectopic pregnancy
  • A miscarriage following an unsuspected pregnancy
  • A vaginal infection
  • A sexually transmitted infection

Although not a common in women of childbearing age, cancer of the vaginal walls, uterus, cervix and ovaries is also a rarer cause of abnormal vaginal bleeding.

What tests can diagnose abnormal vaginal bleeding?

First, you should know only a doctor can diagnose abnormal vaginal bleeding.

Before carrying out a clinical examination, the doctor will ask the patient (or legal caregiver) about their symptoms, when they began and also her medical history. The doctor will also consider the patient’s history of menstruation, as well as sexual events that can sometimes be related to episodic abnormal bleeding, etc.

The doctor identifies the necessary assessments to be made during the clinical examination based on the answers to the above questioning. The tests can therefore differ from case to case, ranging from palpation of the abdomen to a transvaginal ultrasound examination. A urine-based pregnancy test is also often done at the time of the consultation, as well ordering blood tests.

How is it treated?

If the abnormal vaginal bleeding is hormonal in nature, birth control pills or other forms of hormones may be prescribed.

If rarer causes, such as benign tumors, fibroids or cancers, are involved, various medical steps are taken to treat or remove them.

In fact, the presence of symptoms, such as uterine pain, can also be treated. Pain relievers, including acetaminophen and ibuprofen, are very effective in relieving the pain that accompanies abnormal uterine bleeding. However, they have no effect on the bleeding itself.

Prevention of vaginal bleeding

As previously indicated, the cause of abnormal vaginal bleeding is mostly hormonal in nature. This causes an imbalance that is very often beyond our control in terms of prevention. 

However, if the diagnosis reveals a cause, such as a bleeding disorder, for example, clinical methods are implemented to prevent future abnormal bleeding. Once again, it is up to the attending physician to make the best recommendations to their patient as to the prevention methods to undertake.

When should a doctor be consulted?

As soon as signs of abnormal vaginal bleeding appear, it is wise to consult your doctor or gynecologist. In fact, only a doctor will be able to confirm whether or not these signs indicate an imbalance large enough to be treated.

They will also be able to suggest further tests if they deem it appropriate, with the aim of ruling out other possible causes.

If in doubt, you can always call a healthcare professional like your pharmacist. They will not only reassure you, but also give you clear avenues to explore and make recommendations. They may also refer you to a doctor for an evaluation, if necessary. 

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