Abnormal Vaginal Bleeding

Normal vaginal bleeding (menstruation) occurs every 28 to 35 days in every woman. Abnormal vaginal bleeding is any bleeding unrelated to normal menstruation. This can include spotting of small amounts of blood (between periods), or menstrual flow which is heavier than normal.  

Causes of Abnormal Bleeding

The causes for abnormal vaginal bleeding rank in risk of occurrence according to women’s age. Some causes are:

  • Hormonal changes - including thyroid disorder

  • Contraception pills or intrauterine device (IUCD)

  • Pregnancy related

  • Infection of the vagina or uterus

  • Problem with blood clotting

  • Cancer of the uterus, vagina or cervix

  • Trauma to the vagina

  • Polyps or fibroids (abnormal outgrowth of tissues or tumours)

  • Certain diseases affecting clotting (eg: Haemophilia)

Symptoms of Abnormal Bleeding

Symptoms of abnormal vaginal bleeding include bleeding between periods or after sex, spotting after menstruation, bleeding heavier or for more days than normal, and bleeding after menopause.

Diagnosis of Abnormal Bleeding

Dr Cook will examine your family health history as well as complete details of your menstrual cycles (dates, length, and type of bleeding). You will also have a physical examination and blood tests to check your hormonal levels to diagnose the cause of your bleeding.

Dr Cook may also order a pregnancy test to rule out the possibility of pregnancy. A range of imaging tests such as ultrasound or MRI scans, which produce images of your internal organs, may also be ordered to diagnose irregular bleeding.

A cervical smear and swab may be taken and sent for sampling to determine any abnormalities.

Treatments for Abnormal Bleeding

The types of treatment for abnormal vaginal bleeding are based on many factors such as cause of bleeding, age and whether you want to have a child.

Most cases of abnormal vaginal bleeding can be treated with medications, except for few cases that may require surgery.

Medications for Abnormal Bleeding:

Hormonal medications used to treat abnormal bleeding depend on whether or not you want to get pregnant and your age. Hormones can be given as injections, vaginal creams or through intrauterine devices (Mirena).

The hormones are slowly released into the body by these means and control the abnormal bleeding. Dr Cook may prescribe other medications such as anti-inflammatory drugs or antibiotics to reduce bleeding.

Surgical treatment for Abnormal Bleeding:  

Dr Cook will recommend surgical treatment if the bleeding is caused by:

  • polyps or fibroids. Surgery is performed to excise the polyps or fibroids by a procedure called hysteroscopy, which uses a flexible tube or endoscope.

  • endometrial ablation (burning the lining of the uterus) to reduce bleeding may also be performed. This procedure is reserved for women who finished their family, as accidental pregnancy after this procedure can be complicated. This is a day stay procedure.

  • hysterectomy (surgical removal of the uterus) may be considered if all other forms of treatments have failed. You can no longer conceive after hysterectomy.

Along with these treatments, you can take good care of yourself by eating a well-balanced diet, exercising and getting a proper amount of sleep.