Abnormal Vaginal Bleeding: Causes

What causes abnormal vaginal bleeding?

The causes of abnormal bleeding can vary depending on a woman's age and her stage in life. Young women in the first few years of their menstrual periods may experience some abnormal vaginal bleeding. Women of childbearing age may experience gynecologic disorders, such as fibroids, polyps, or complications from contraceptive devices. Women who are approaching menopause may have irregular periods or may skip periods entirely. Endometrial hyperplasia, an excessive or abnormal thickening of the uterine lining, can also cause abnormal vaginal bleeding and may lead to cancer of the uterus.

The hormones estrogen and progesterone control the menstrual period. If these hormones are out of balance or not available, abnormal vaginal bleeding may occur. Women with thyroid disorders also have hormonal imbalances that can result in abnormal vaginal bleeding.

Gynecologic causes of abnormal vaginal bleeding

• Abnormal vaginal bleeding may be caused by gynecologic disorders including:
• Cyst (benign sac that contains fluid, air, or other materials)
• Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
• Endometrial hyperplasia (thickening of the lining of the uterus)
• Menorrhagia (heavy bleeding during menstrual period)
• Miscarriage
• Polycystic ovary syndrome
• Some sexually-transmitted diseases
• Uterine fibroids or noncancerous tumors of the uterus
• Uterine polyps or masses in the endometrium

Hormonal causes of abnormal vaginal bleeding

Abnormal vaginal bleeding can also be caused by hormonal imbalances including:

• Changes in levels of estrogen or progesterone
• Complications from hormone-releasing contraceptives (birth control pill, patch or injection; intrauterine devices)
• Hyperthyroidism (overactive thyroid)
• Menopausal transition

Serious or life-threatening causes of abnormal vaginal bleeding

In some cases, abnormal vaginal bleeding may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a medical professional. These conditions include:

• Cervical cancer (cancer of the uterine cervix)
• Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)
• Endometrial cancer (cancer of the lining of the uterus)
• Ovarian cancer
• Pelvic inflammatory disease (PID, an infection of a woman’s reproductive organs)
• Vaginal cancer
• Vaginal or abdominal trauma

Questions for diagnosing the cause of abnormal vaginal bleeding

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your abnormal vaginal bleeding including:

• Are you pregnant?
• When did you first notice the abnormal vaginal bleeding?
• Have you noticed any changes in your menstrual periods?
• Is your menstrual period particularly heavy or prolonged?
• Have you missed any menstrual periods?
• Do you have spotting or bleeding between menstrual periods?
• Do you have any other symptoms, such as fatigue or rapid heart rate?

What are the potential complications of abnormal vaginal bleeding?

The causes and complications of abnormal vaginal bleeding can vary depending on a woman's age and her stage in life. Because abnormal vaginal bleeding can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

• Anemia (low red blood cell count)
• Cancer of the uterus
• Inability to participate normally in activities
• Infertility
• Spread of cancer
• Spread of infection

References:

Abnormal uterine bleeding. ACOG, American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp095.cfm. Accessed May 16, 2011.

Vaginal bleeding. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/vaginalbleeding.html. Accessed May 16, 2011.