Understanding Vaginal Bleeding: What’s Normal and What’s Not

Sep 21, 2023 | Gynecology

Vaginal bleeding is a natural part of a woman’s menstrual cycle. However, bleeding outside of the typical menstrual cycle, or experiencing symptoms that deviate from your norm, can be concerning. Recognizing the difference between what’s considered normal and abnormal vaginal bleeding is crucial for one’s reproductive health.

Normal Vaginal Bleeding

Menstrual Periods: The regular menstrual flow typically occurs every 21 to 35 days and lasts about 3 to 7 days. These cycles can be shorter or longer and might vary in flow intensity. It’s crucial to understand your personal cycle, as it can help you identify any unusual changes.

Spotting Between Periods: Occasional light bleeding or spotting between periods can be due to various reasons, such as ovulation or the use of birth control pills. This is generally considered normal unless it becomes frequent or heavy.

Abnormal Vaginal Bleeding

Heavy Periods (Menorrhagia): When menstrual bleeding is excessively heavy or prolonged— soaking through one or more sanitary pads or tampons every hour for several hours—it’s termed as menorrhagia.

Bleeding Between Periods: Regular and heavy bleeding between menstrual cycles might indicate underlying issues, such as hormonal imbalances, infections, or other medical conditions.

Postmenopausal Bleeding: After menopause, any vaginal bleeding is deemed abnormal. Causes could range from thinning of the vaginal lining to more serious conditions like cancer.

Bleeding After Sex: Occasional light bleeding after intercourse can be due to reasons like vaginal dryness or cervical polyps. However, persistent bleeding after sex should be examined by a healthcare professional.

Potential Causes of Abnormal Vaginal Bleeding

Hormonal Imbalances: Imbalances in estrogen and progesterone can cause the endometrium to overgrow, shed irregularly, and lead to heavy bleeding.

Uterine Fibroids and Polyps: Benign growths in the uterus can cause heavy menstrual bleeding or bleeding between periods.

Medications: Some anticoagulants and anti-inflammatory medications can lead to increased bleeding. Birth control pills can also cause spotting.

Pregnancy Complications: Ectopic pregnancy or miscarriage can cause abnormal vaginal bleeding.

Cancer: Uterine, ovarian, and cervical cancer can manifest as abnormal bleeding, especially postmenopausal bleeding.

Other Medical Conditions: Conditions like pelvic inflammatory disease, endometriosis, and bleeding disorders can cause abnormal vaginal bleeding.

When to Seek Medical Attention

Always consult with a healthcare provider if you’re concerned about vaginal bleeding. Specific instances to seek care include:

  • Heavy bleeding or menstrual periods lasting more than seven days.
  • Bleeding after menopause.
  • Bleeding after sex.
  • Menstrual cycles less than 21 days or more than 35 days apart.
  • Any bleeding that deviates from your norm or causes concern.

Understanding your body and the intricacies of your menstrual cycle is crucial. While variations in vaginal bleeding can be typical for some women, it’s essential to distinguish between normal and abnormal patterns. Early detection and treatment of underlying issues can pave the way for better reproductive health. Know your body and speak to your healthcare provider if you notice any unusual changes.

For more information see the articles below or call us to make an appointment with your provider.

CDC: https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html#:~:text=If%20you%20have%20bleeding%20that,medical%20history%20and%20menstrual%20cycles.

Cleveland Clinic: https://my.clevelandclinic.org/health/symptoms/17899-vaginal-bleeding#:~:text=Most%20vaginal%20bleeding%20can%20be,a%20cause%20for%20your%20bleeding.

Mount Sinai: https://www.mountsinai.org/health-library/symptoms/vaginal-bleeding-between-periods