Abnormal vaginal bleeding

Abnormal or irregular vaginal bleeding is any bleeding from your vaginal area that is not part of a regular period. It can be caused by infection and hormonal changes, but can also be a symptom of more serious problems.

There is a wide range in what is ‘normal’ for periods. They can last from 3 to 10 days, and occur every 3 to 6 weeks. Variations can be caused by age, stress, diet, exercise and other medical conditions.

Causes of abnormal vaginal bleeding

Bleeding that is not a normal period could be caused by:  

  • hormonal changes (such as starting menopause or polycystic ovary syndrome)
  • contraception such as the pill, injection, implant or IUD (intrauterine device)
  • infection in your vagina or uterus
  • fibroids or polyps inside your uterus
  • trauma to your vagina
  • some medications such as anticoagulants 
  • underlying health problems such as bleeding or thyroid disorders
  • cancer in the lining of your uterus, your cervix or vagina (this is rare).

When to see your doctor

See your doctor if you are worried about abnormal bleeding or if your usual pattern of periods has changed – especially if you have more frequent or heavier bleeding.

If you are past the menopause (no longer have normal periods) see your doctor if you have any vaginal bleeding.

It is also important to see your doctor if you get any bleeding after having sex.

Call Healthline 0800 611 116 if you are unsure what you should do.

Diagnosis

Your doctor may be able to work out what is causing the irregular bleeding by examining you and checking your medical history. But you may need to have further tests. These could include:

  • cervical smear and swabs
  • pregnancy test
  • blood tests
  • ultrasound
  • endometrial sampling, which is when a small tube like a straw is passed through the cervix and the lining of the uterus is gently collected by suction
  • dilation and curettage (D&C), which involves gently widening the cervix and scraping away the lining of the uterus
  • hysteroscopy, where the lining of the uterus is viewed with an instrument.

A D&C and hysteroscopy would be done under an anaesthetic, and the two procedures may be done together. 

Treatment

Treatment for the bleeding depends on what has caused it, but may include:

  • anti-inflammatory drugs
  • antibiotics
  • change of contraception
  • hormone therapy, including slow-release implants such as Mirena
  • anti-bleeding agents such as tranexamic acid
  • surgery to remove fibroids, polyps or cancers
  • treatment for any underlying health problem.

Self-care

If you have irregular bleeding, make sure you:

  • get plenty of sleep
  • eat a well-balanced diet
  • do some gentle exercise
  • keep a diary of your symptoms to show your doctor.

If you suffer from pain with your bleeding, try these ideas.

  • Rest – curl your knees up to your chest and lie on your side.
  • Place something warm, such as a hot water bottle or wheat bag, on your tummy.
  • Do some gentle exercise.
  • Rub or massage where it hurts.
  • Take painkillers such as paracetamol or ibuprofen, but avoid aspirin.
  • Try relaxation techniques.
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