Abnormal Vaginal Bleeding Q&A

Vaginal bleeding is considered abnormal if it occurs outside the normal menstrual cycle, during pregnancy, or after the menopause. Although there is often a simple explanation, you should always see your doctor if you have any abnormal vaginal bleeding. If you are pregnant and you are bleeding, you should consult your doctor or midwife at once.

  • Are you pregnant?

    • More than 14 weeks pregnant
      • Possible cause Bleeding at this stage of pregnancy could be due to a problem with the placenta (see Vaginal bleeding in pregnancy).

        Medical help URGENT! Phone your doctor or midwife immediately! Rest in bed until you receive medical advice.

    • Less than 14 weeks pregnant

      Do you have unaccustomed pain in the lower back or abdomen?

      • Lower back pain
        • Possible cause You may be having a miscarriage or you may have an ectopic pregnancy.

          Medical help URGENT! Phone your doctor or midwife immediately! Rest in bed until you receive medical advice.

      • Abdominal pain
        • Possible cause You may be having a miscarriage or you may have an ectopic pregnancy.

          Medical help URGENT! Phone your doctor or midwife immediately! Rest in bed until you receive medical advice.

      • Neither
        • Possible cause Bleeding at this stage of pregnancy could be the first sign of a threatened miscarriage.

          Medical help URGENT! Phone your doctor or midwife immediately! Rest in bed until you receive medical advice.

    • Not pregnant

      Is the bleeding similar to that of a normal period?

      • Like a period

        Does either of the following apply?

        • You have only recently started having periods
          • Possible cause Irregular periods are fairly common in the first year or so of menstruation.

            Medical help Make an appointment to see your doctor if you are concerned.

        • You are over 40
          • Possible cause Your periods may become irregular as you approach the menopause (see Irregular periods and Menopausal problems).

            Medical help Make an appointment to see your doctor if you are concerned, if there has been a gap of more than 2 months between periods, or if the bleeding is unusually heavy.

        • Neither
          • Possible cause Having an occasional irregular period is unlikely to indicate that you have a serious problem if the period was normal in all other respects.

            Medical help Make an appointment to see your doctor if you are concerned or if your pattern has not returned to normal within three menstrual cycles.

      • Different

        How long has it been since your last period?

        • Less than 6 months

          Have you had sexual intercourse in the past 3 months?

          • Intercourse

            Have you noticed bleeding within a few hours of intercourse?

            • Bleeding after intercourse
            • Bleeding unrelated to intercourse
              • Possible cause Bleeding, especially if it is accompanied by pain in the lower abdomen, may be the first sign of an ectopic pregnancy or of an impending miscarriage, even if you were not aware of being pregnant.

                Medical help URGENT! Phone your doctor immediately!

          • No intercourse
            • If you cannot identify a possible cause for your abnormal bleeding from this chart, make an appointment to see your doctor.

        • More than 6 months
          • Possible cause Bleeding after the menopause may be due to a minor hormonal problem, but the possibility of cancer of the uterus needs to be ruled out.

            Medical help URGENT! Phone your doctor immediately!

Warning

Bleeding in pregnancy

If you have any vaginal bleeding during pregnancy, you should contact your doctor or midwife urgently. If the bleeding is heavy, call an ambulance. Although most causes of bleeding are not serious, it is important to rule out miscarriage or a problem such as a low-lying placenta (see Placenta praevia) or partial separation of the placenta from the wall of the uterus (see Placental abruption).

Warning

Hormonal contraceptives

In the first few menstrual cycles after either starting hormonal contraception or changing to a different type of contraceptive pill, spotting is fairly common (see Contraception). If abnormal bleeding persists or develops when there have previously been no problems, you should consult your doctor. He or she may examine you and change the dosage or type of hormonal contraceptive that has been prescribed.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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