Many women experience abnormal vaginal
bleeding or spotting between periods sometime in their lives. Vaginal bleeding
is considered to be
abnormal if it occurs:
- When you are not expecting your menstrual
- 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
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
- Spotting to minimal bleeding may be normal,
but any bleeding during pregnancy needs to be evaluated by your
- Heavy vaginal bleeding or bleeding that occurs before 12
weeks may mean a serious problem, including an
ectopic pregnancy or
- Heavy vaginal bleeding or
bleeding that occurs after 12 weeks also may mean a serious problem, such
- Ovulation can cause
- Polycystic ovary syndrome (PCOS) is a hormone imbalance that interferes with normal
ovulation which can cause abnormal bleeding.
- 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
intrauterine device (IUD) also may increase your
chances of spotting or heavy periods. For more information on the IUD, see the
- Infection of the
pelvic organs (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
Exposure to Sexually Transmitted Infections.
- Pelvic inflammatory disease (PID)
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:
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
perimenopause. 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.
Check your symptoms to decide if and when you should see a doctor.