Abnormal Vaginal Bleeding

Abnormal vaginal bleeding occurs between menstrual periods, after sex, or after menopause. Menstrual periods that are heavier or last longer than usual or last more than seven days also are considered abnormal.

Your doctor will likely perform a physical and pelvic exam and may test your blood, hormone levels and thyroid function to determine if you are pregnant or infected with a sexually transmitted disease.

Imaging tests such as pelvic ultrasound, transvaginal ultrasound, ultrasound of the uterus, pelvic MRI, hysteroscopy or endometrial biopsy also may be used to help diagnose your condition.

Treatment depends on the underlying cause and may include medication, uterine fibroid e-mobolization, endometrial ablation or surgical intervention.

A range of causes

In many women, the cause of the irregular bleeding is not found. For others, the cause depends on their age and the site of bleeding. Once pregnancy has been ruled out, some of the known causes include:

• Hormonal changes
• Contraception such as the pill, injection or IUD (intrauterine device)
• Infection in the vagina or uterus
• Fibroids or polyps inside the uterus
• Trauma to the vagina
• Some medications such as anticoagulants or anti-epilepsy drugs
• Underlying health problems such as bleeding or thyroid disorders
• Cancer in the lining of the uterus, the cervix or vagina (rare).

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