Abnormal Vaginal Bleeding - Reasons Behind It!

Monthly menstrual cycles become a part of woman’s life after a certain stage. They get accustomed to it and adapt their lifestyle too. However, there could be abnormal vaginal bleeding, which is defined as:
Bleeding that is outside of the menstrual cycle (bleeding outside of the expected dates). This is also known as intermenstrual bleeding or metrorrhagia.

• Menstrual bleeding that is abnormally low or high as compared to your regular flow
• Before menarche (before 9 years of age), during pregnancy, or after menopause

Causes: It is important to realise that abnormal vaginal bleeding is only a symptom and not the disease per se. In most women, there are underlying reasons that lead to abnormal bleeding, some of them are listed below.
In some women, ovulation can cause a mid-cycle bleeding, which becomes a pattern for most women, and they know it is nothing to worry about.

1. Miscarriage or ectopic pregnancy: Vaginal bleeding is the most common symptom of miscarriage and requires immediate medical attention.
2. Hormonal imbalances: This can be caused due to starting and stopping of birth control pills, thyroid abnormalities, or ovarian malfunctions. This requires investigation and management based on the underlying cause.
3. Polycystic ovarian syndrome (PCOS): This presence of multiple cysts in the ovaries also has hormonal changes and can cause bleeding in affected women.
4. Infections: Infections along the gynecologic tract including the vagina, cervix, uterus, fallopian tubes, and ovaries can cause bleeding. Sexually transmitted infections including gonorrhoea and chlamydia are also causes for bleeding
5. Pelvic inflammatory disease (PID): It can cause inflammation of the entire gynecologic tract and induce bleeding
6. An abnormally placed intrauterine device (IUD): It can also alter the regular menstrual flow.
7. Other reasons: Fibroids, endometriosis, cancers of the uterine cavity are other reasons for abnormal vaginal bleeding.

Prevention/Management of vaginal bleeding: Abnormal bleeding requires investigation to find out the underlying cause and needs to be treated accordingly.

1. Birth control: When using birth control measures, be it pills or patches, expect some bleeding during the first 3 months before things settle down. Similarly, intrauterine devices can cause some bleeding (foreign body effect).
2. Pregnancy complications: Bleeding during pregnancy requires immediate medical attention. In most cases, it indicates a miscarriage or ectopic pregnancy (where the embryo is planted in the fallopian tubes and not the uterus).
3. Infections: While STDs can be prevented, once acquired, like other infections, they also require antibiotics and supportive care.
4. Medical conditions: Be it polycystic ovaries, fibroids, endometriosis, cancer, or PID, all these require detailed investigation and management on a case-to-case basis.

If you experience abnormal vaginal bleeding, do not ignore it and reach out for medical help.

In case you have a concern or query you can always consult an expert & get answers to your questions!