Vaginal bleeding that is not related to menstruation
Normally, vaginal bleeding occurs only during a period. Bleeding that occurs outside menstruation is abnormal. In women under the age of 35, abnormal vaginal bleeding is often the result of starting oral contraceptives or of using an intrauterine contraceptive device (IUD). Abnormal bleeding caused by a disorder of the reproductive organs is more common in women over this age.
Light bleeding between periods, known as spotting, is common in the first few menstrual cycles after starting oral contraceptives or changing to a different type of pill. Spotting is usually brought on by the body adjusting to changes in hormone levels, but this type of bleeding can also be associated with using an IUD.
Abnormal bleeding, especially within a few hours of sexual intercourse, may indicate a disorder of the cervix, such as cervical ectopy or, rarely, cancer of the cervix. In some cases, pelvic inflammatory disease may cause bleeding after sex, although this condition can also cause abnormal vaginal bleeding that is not related to sex. In older women, sex may damage the walls of the vagina, which become thinner and more fragile after the menopause, causing bleeding.
Abnormal vaginal bleeding that is not associated with sexual intercourse or contraception may be caused by a disorder such as fibroids. Loss of blood from the uterus can also occur in early pregnancy and could indicate a miscarriage or ectopic pregnancy. Various disorders of the female reproductive organs may cause postmenopausal bleeding, such as cancer of the uterus.
If you notice abnormal bleeding, you should see your doctor immediately so that the cause can be investigated.
Your doctor may be able to make a diagnosis based on the timing of the bleeding and a physical examination. You may also need to have tests, such as a cervical smear test to check for disorders of the cervix, ultrasound scanning to look at the uterus, endoscopy to view the inside of the uterus (see Hysteroscopy), or endometrial sampling, in which a small sample of tissue is taken from the lining of the uterus for microscopic examination.
The treatment for abnormal vaginal bleeding depends on the cause. Spotting caused by oral contraceptives usually clears up spontaneously, or it may be necessary to change the dose or type of pill. Hormone treatments can be used to restore the elasticity of fragile vaginal walls in older women. Surgery may be required to treat more serious underlying disorders. In most cases, abnormal vaginal bleeding disappears once the cause has been treated.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.