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Michael Fields, MD Michael Fields, MD

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Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein.

Abnormal Vaginal Bleeding

Overview

Abnormal vaginal bleeding is unexpected bleeding from the vagina. The source of the bleeding may be from the vagina or uterus. If it comes from the uterus, it's called abnormal uterine bleeding. Abnormal bleeding from the vagina can be caused by things like a disease, an injury to the vagina, or a problem with the cervix. These may be from sex, an object in the vagina, an infection, or polyps on the cervix.

When you have unexpected bleeding, it's important to let your doctor know. Your doctor can do an exam and tests to see if the bleeding is coming from your vagina or uterus. They can also check for problems. Treatment depends on the cause of the bleeding.

Bleeding during pregnancy is a different problem. If you are pregnant and have any amount of bleeding from the vagina, be sure to tell your doctor.

Check Your Symptoms

Are you having any abnormal vaginal bleeding?
Bleeding is abnormal if it occurs at a time when you aren't expecting it or if it's a lot heavier or lighter than what you are used to.
Yes
Abnormal vaginal bleeding
No
Abnormal vaginal bleeding
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Are you pregnant?
Yes, you know that you're pregnant.
Pregnancy
No, you're not pregnant, or you're not sure if you're pregnant.
Pregnancy
Have you been skipping periods or bleeding a lot less than usual?
Yes
Periods are absent or lighter than usual
No
Periods are absent or lighter than usual
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Has vaginal bleeding started before age 9?
Yes
Vaginal bleeding started before age 9
No
Vaginal bleeding started before age 9
Do you feel lightheaded or dizzy, like you are going to faint?
It's normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.
Yes
Feels faint
No
Feels faint
Do you have new pain in your lower belly, pelvis, or genital area that is different than your usual menstrual cramps?
Yes
Lower abdominal, pelvic, or genital pain
No
Lower abdominal, pelvic, or genital pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
When this bleeding was heaviest, was it severe, moderate, mild, or minimal?
Severe
Severe bleeding
Moderate
Moderate bleeding
Mild
Mild bleeding
Minimal
Minimal bleeding
Has this amount of bleeding been going on for 4 hours or longer?
Yes
Bleeding 4 hours or more
No
Bleeding 4 hours or more
Are you bleeding now?
Yes
Vaginal bleeding now
No
Vaginal bleeding now
Is the bleeding happening at an expected time during your menstrual cycle?
Yes
Bleeding is at expected time during menstrual cycle
No
Bleeding is at expected time during menstrual cycle
Do you think that the symptoms may have been caused by sexual abuse?
Yes
Possible sexual abuse
No
Possible sexual abuse
Have you been bleeding for more than 2 weeks without stopping?
Yes
Bleeding for more than 2 weeks without stopping
No
Bleeding for more than 2 weeks without stopping
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Do you have a rash that looks like a sunburn?
Yes
Sunburn-like rash
No
Sunburn-like rash
Do you have any bleeding after intercourse or douching?
Yes
Vaginal bleeding after intercourse or douching
No
Vaginal bleeding after intercourse or douching
Do you think that a medicine may be causing the bleeding?
Think about whether the bleeding started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing vaginal bleeding
No
Medicine may be causing vaginal bleeding
Do you use a form of birth control that contains hormones?
This could be birth control pills, implants, vaginal rings, skin patches, injections, or an IUD that contains hormones.
Yes
Hormonal birth control method
No
Hormonal birth control method
If your periods have stopped because of menopause, has it been at least 6 months since your last one?
Yes
In menopause and 6 months since last period
No
In menopause and 6 months since last period
Are you taking hormone replacement therapy, such as estrogen or progestin?
Hormones can cause changes in your normal bleeding patterns, especially when you first start taking them.
Yes
Hormone replacement therapy
No
Hormone replacement therapy
Have you had abnormal bleeding for at least 2 cycles or more than once a month?
Yes
Bleeding has occurred for at least 2 cycles or more than once per month
No
Bleeding has occurred for at least 2 cycles or more than once per month
Have your symptoms lasted longer than 2 weeks?
Yes
Symptoms for more than 2 weeks
No
Symptoms for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
HomeTreatment
WhereToGo

Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered severe. If you are pregnant: You may have a gush of blood or pass a clot, but if the bleeding stops, it is not considered severe.

Moderate bleeding means that you are soaking more than 1 pad or tampon in 3 hours.

Mild bleeding means that you are soaking less than 1 pad or tampon in more than 3 hours.

Minimal vaginal bleeding means "spotting" or a few drops of blood.

Many prescription and nonprescription medicines can cause changes in vaginal bleeding. A few examples are:

  • Aspirin and other medicines (called blood thinners) that prevent blood clots.
  • Corticosteroids, such as prednisone.
  • Hormone therapy.
  • Thyroid medicines.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
HomeTreatment
WhereToGo

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
HomeTreatment
WhereToGo

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Pregnancy-Related Problems
Missed or Irregular Periods

Self-Care

With some types of vaginal bleeding, it may be okay to wait to see if the bleeding stops on its own. If the bleeding continues or gets worse, see your doctor to find out the reason for the bleeding.

If you use tampons for abnormal vaginal bleeding, be sure to change them often. And don't leave one in place when the bleeding has stopped. A tampon left in the vagina may put you at risk for toxic shock syndrome (TSS). TSS is a rare but deadly illness. It develops suddenly after a bacterial infection rapidly affects several organ systems.

If you are age 40 or older, you may be experiencing perimenopause.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • New fever or pain.
  • Bleeding increases or becomes more severe.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

You can help your doctor diagnose and treat your condition by being prepared for your appointment.

Credits

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.