Read below about vaginal bleeding, including causes, treatment options and remedies. Or get a personalized analysis of your vaginal bleeding from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

This symptom can also be referred to as:
Spotting

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Vaginal Bleeding Symptoms

Many women of child-bearing age have experienced symptoms of vaginal bleeding and thought, "it must be that time of the month again." However, at times, symptoms of vaginal bleeding should make women in this age range stop and think "…. or is it?"

Vaginal bleeding symptoms can be normal or abnormal [1, 17]. Normal vaginal bleeding (menstruation) happens every 21 to 35 days. The bleeding occurs because the uterus sheds its lining, and a new reproductive cycle begins. Vaginal bleeding symptoms unrelated to a normal menstrual cycle are considered abnormal.

The definition of a "normal menstrual cycle" is different for every woman [2, 17]. A menstrual cycle for one woman may last for a few days but for another woman may last a week or more. Be cautious of symptoms of vaginal bleeding that are different from your regular pattern.

For example, abnormal patterns of vaginal bleeding include bleeding that:

  • Is lighter or heavier than your normal flow [1]
  • Occurs when you are not expecting your menstrual period
  • Occurs during a time in your life when it is not expected such as before puberty, during pregnancy or after menopause (which is defined as 12 or more consecutive months without a menstrual period).

Being able to recognize patterns of vaginal bleeding that stray outside of your normal menstrual cycle is very important. You should always seek medical care and follow up with your doctor if you experience symptoms of abnormal vaginal bleeding [13].

Vaginal Bleeding Causes Overview

The causes of vaginal bleeding are numerous [3, 17], and the list can seem daunting. However, not all abnormal vaginal bleeding indicates a serious condition. This is why it is important to see your doctor in order to evaluate the cause of your symptoms and receive proper treatment.

Pregnancy-related factors:

  • Consider possible pregnancy if you experience abnormal vaginal bleeding symptoms. The bleeding can signify a pregnancy or problems with a pregnancy such as miscarriage or ectopic pregnancy [7, 21].

Infections:

  • Bacterial Infections: Infections such as chlamydia and gonorrhea can infect the reproductive tract and cause irritation and inflammation, especially after sexual intercourse, that can result in abnormal vaginal bleeding and other STD symptoms in women [3].
  • Fungal Infections : Fungal infections such as yeast also often affect the vaginal canal and result in inflammation that results in bleeding.

Benign uterine conditions:

  • Obstruction: Sometimes abnormal vaginal bleeding can be caused by masses in the reproductive organs such as fibroids that are not cancerous.

    • Hormonal Imbalances: Conditions of the uterus that occur as a result of hormonal imbalances such endometriosis and adenomyosis can result in heavy periods that are not your usual pattern [9, 20].

Medications and medical devices:

  • Contraceptives methods: Birth control pills can cause vaginal bleeding symptoms if they are not used properly [14, 17]. Abnormal vaginal bleeding is also a known side effect of Intrauterine devices (IUDs).
  • Medications: Medications such as blood thinners can cause you to bleed more during your menstrual cycle.

Blood disorders:

  • Functional: Medical conditions such as von Willebra disease (clotting disorder) that affect the way different components of your blood function can result in vaginal bleeding [3].
  • Synthetic: Your liver and to lesser extent your kidney are organs that are very important in making the components of your blood that regulate bleeding. If there is a malfunction in these organs such as liver disease or kidney disease, you may experience abnormal vaginal bleeding as well.

Cancers:

  • Vaginal bleeding in women who have started menopause may be caused by cancers of any part the reproductive tract such as the ovary, vagina and uterus.
  • There is also a precancerous condition called endometrial hyperplasia that can cause abnormal vaginal bleeding.

Endocrine system factors:

  • Hormone imbalances such as Polycystic Ovarian Syndrome (PCOS) can interfere with your normal menstrual cycle and cause abnormal vaginal bleeding [6].

Trauma

  • Blunt trauma, penetrating injury to the vagina/cervix and sexual abuse can all cause vaginal bleeding [3].
  • A retained tampon (multiple days) can also lead to trauma that results in vaginal bleeding.

A.I. Health Assistant Causes for Vaginal Bleeding

The list below shows results from the use of our A.I. Health Assistant by Buoy users who experienced vaginal bleeding. This list does not constitute medical advice.

  1. 1.Normal Case of Spotting

    Spotting is vaginal bleeding that occurs between periods. Many women experience spotting between periods and it is often nothing to worry about. Oral contraceptives (the pill) can cause spotting as a side effect, especially if they have a low estrogen dose, someone started on them recently or does not take them on the same time everyday. Additionally, hormone supplements that only contain estrogen (often used in menopause) can cause spotting as well.

    A few days

    Rarity:
    Common
    Top Symptoms:
    vaginal bleeding or bloody discharge, bloody vaginal discharge, mild unexpected vaginal bleeding, vaginal bleeding, vaginal discharge
    Symptoms that always occur with normal case of spotting:
    vaginal bleeding or bloody discharge
    Symptoms that never occur with normal case of spotting:
    severe unexpected vaginal bleeding, vaginal pain, vaginal itch or burning, bleeding after sex, severe abdominal pain
    Urgency:
    Wait and watch
  2. 2.Ovulation Pain (Mittelschmerz) or Midcycle Spotting

    Mittelschmerz, also known as ovulation pain or mid-cycle pain, is abdominal pain that occurs around the time the egg is released from an ovary. Ovulation can sometimes cause some mild vaginal bleeding, spotting or blood-stained/brown discharge as well.

    As ovulation occurs monthly, it's possible you will experience this pain once a month.

    Rarity:
    Common
    Top Symptoms:
    abdominal pain (stomach ache), last period approximately 2 weeks ago, vaginal bleeding, bloody vaginal discharge, pelvis pain
    Symptoms that always occur with ovulation pain (mittelschmerz) or midcycle spotting:
    last period approximately 2 weeks ago
    Urgency:
    Self-treatment
  3. 3.Polycystic Ovary Syndrome

    Polycystic ovary syndrome is a common hormone disorder characterized by irregular periods, acne, and fertility issues.

    Symptoms are well controlled with medicines including combined hormonal birth control.

    Rarity:
    Common
    Top Symptoms:
    fatigue, vaginal bleeding, pelvis pain, depressed mood, painful periods
    Symptoms that always occur with polycystic ovary syndrome:
    oligo/amenorrhea or hyperandrogenism
    Urgency:
    Primary care doctor
  4. 4.Ectopic Pregnancy

    Ectopic pregnancy occurs when the fertilized egg implants outside of the uterus. The vast majority of ectopic pregnancies occur in the fallopian tubes.

    Treatment depends on how far the pregnancy has progressed but in all cases leads to the termination of the embryo.

    Rarity:
    Uncommon
    Top Symptoms:
    abdominal pain (stomach ache), nausea or vomiting, vaginal bleeding, pelvis pain, moderate abdominal pain
    Symptoms that never occur with ectopic pregnancy:
    disapearance of periods for over a year
    Urgency:
    Hospital emergency room

    Vaginal Bleeding Checker

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  5. 5.Uterine Fibroids

    Uterine fibroids are noncancerous tumors in the uterus. They are common in women of childbearing age.

    Treatment ranges from medication to surgical removal of the fibroid.

    Rarity:
    Common
    Top Symptoms:
    vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period
    Urgency:
    Primary care doctor
  6. 6.Endometriosis

    Endometriosis is a disorder in which the tissue that normally lines the uterine walls grows outside the uterus.

    Recovery is dependent on severity of disease and treatment approach.

    Rarity:
    Uncommon
    Top Symptoms:
    vaginal discharge, abdominal pain (stomach ache), vaginal bleeding, pelvis pain, painful periods
    Urgency:
    Primary care doctor
  7. 7.Cervical Polyp

    Cervical polyps are noncancerous growths in the cervical canal. Associated symptoms include spotting and bleeding during or after sexual intercourse.

    If symptoms are bothersome, the polyp can be surgically removed.

    Rarity:
    Uncommon
    Top Symptoms:
    vaginal discharge, vaginal bleeding, bleeding after sex, heavy menstrual flow, mucousy vaginal discharge
    Urgency:
    Primary care doctor
  8. 8.Pelvic Inflammatory Disease

    Pelvic inflammatory disease (PID) is an infection of the female genital structures like the uterus, fallopian tube, ovary, and the surrounding abdominal wall. It is typically caused by N. Gonorrhoeae or C. Trachomatis.

    Prognosis after treatment within 3 days of symptom onset is great (88%-100%). Those that are hospitalized, older, or have had gynecological surgery have a worse time with this infection.

    Rarity:
    Common
    Top Symptoms:
    fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain
    Symptoms that always occur with pelvic inflammatory disease:
    fever, abdominal pain or unusual vaginal discharge
    Urgency:
    In-person visit
  9. 9.Endometrial Polyp

    Endometrial polyps are noncancerous growths in the uterine cavity. Associated symptoms include spotting and bleeding during or after sexual intercourse.

    If symptoms are bothersome, the polyp can be surgically removed.

    Rarity:
    Rare
    Top Symptoms:
    vaginal discharge, vaginal bleeding, bleeding after sex, heavy menstrual flow, trouble getting pregnant
    Urgency:
    Primary care doctor

Vaginal Bleeding Treatments and Relief

Vaginal bleeding can be discomforting and distressing even during a normal menstrual cycle. Seeking prompt medical attention when you notice symptoms of abnormal bleeding will accelerate your diagnosis and allow you to get the appropriate treatment. Your treatment will depend on the cause of your symptoms and the results of any testing.

Medication:

  • Hormones: Many uterine conditions and endocrine system causes of abnormal bleeding are the result of an imbalance of hormones in the body [15]. Your doctor may prescribe treatment in the form of these hormones in order to restore your body's balance [16, 17].
  • Antibiotics: Your doctor may prescribe antibiotics for certain infections of the reproductive tract that may cause your vaginal bleeding symptoms.
  • Changes to your current regimen: If contraceptive methods or other medications are contributing to your symptoms, your doctor may discuss stopping your current medications in favor of a new regimen [14].
  • Other treatment: If your vaginal bleeding symptoms are caused by an underlying bleeding disorder or systemic disease, your doctor will treat the primary disease first and monitor its effects on your vaginal bleeding.

Surgery:

  • When medications fail some causes of vaginal bleeding can be treated with surgical options that either remove masses or decrease the lining of the uterus [18, 19]. Most cancers of the reproductive organs are removed by surgery [18].

Pregnancy care:

  • If your bleeding is caused by pregnancy-related factors your doctor will discuss available options for care [21].

Seek immediate medical attention if:

  • You have sudden, severe pain in your belly or pelvis area
  • You are soaking through your usual pads or tampons every hour for 2 or more hours.
  • You feel dizzy or lightheaded, or you feel like you may faint.

FAQs About Vaginal Bleeding

Here are some frequently asked questions about vaginal bleeding.

Can stress cause vaginal bleeding?

No, stress cannot cause vaginal bleeding. Stress can, however, cause an earlier or later menstrual cycle and cause bleeding in-line with a new cycle [22]. If you have new mid-cycle bleeding and have not consulted a clinician, you should seek medical evaluation. It may be a sign of anything from a sexually transmitted infection (STI), to fibroids, to a pregnancy, or it may have no definable cause [13, 14, 15].

Why am I bleeding between my periods?

Bleeding between periods can be caused by serious or benign causes. The most dangerous causes often involve pregnancy. A failed pregnancy, a pregnancy in which the egg implants in the fallopian tube, disconnection of the placenta from the uterus, or damage to the uterus can all cause bleeding. If you suspect any of these causes, you should seek medical evaluation as soon and as safely as possible. Otherwise, uterine fibroids, tumor, blood thinners, ruptured ovarian cysts and gynecological infections, and changes in contraceptive drugs can cause spotting [4, 13, 14].

Is vaginal bleeding an early sign of pregnancy?

No, vaginal bleeding is not an early sign of normal pregnancy [15, 21]. If you are pregnant and experience vaginal bleeding, you should visit your OBGYN for evaluation. Vaginal bleeding can be caused by many things other than pregnancy, including sexually transmitted infections, uterine growths called fibroids, and certain types of cancers [4, 13, 14, 15].

Why am I still spotting after my period ends?

Continuous bleeding after a period can be caused by a many things [17, 23]. Most commonly, an abnormally long period may have no discernible cause [14, 15]. If it does not recur, it may require no further investigation. Continuous spotting may be a sign of a disorder in coagulation caused by either medication or a genetic disorder. It may also be a sign of infection of the vagina or cervix.

Why am I experiencing vaginal bleeding after menopause?

Vaginal bleeding after menopause may be due to medications, hyperplasia of the uterus, or some types of uterine cancer [24]. Certain medications containing estrogen or progesterone can cause either hyperplasia or an increase in the amount of tissue in the uterus, which may cause bleeding or an excess sloughing off of tissue — both of which will be seen as vaginal bleeding.

Questions Your Doctor May Ask About Vaginal Bleeding

  • Q.Are you sexually active?
  • Q.Do you use birth control beside condoms?
  • Q.Do you bleed after having sex?
  • Q.Have you ever had any surgeries?

If you've answered yes to one or more of these questions, try our vaginal bleeding symptom checker to find out more.

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Vaginal Bleeding Symptom Checker Statistics

  • People who have experienced vaginal bleeding have also experienced:

    • 30% Bloody Vaginal Discharge
    • 12% Abdominal Cramps (Stomach Cramps)
    • 4% Vaginal Discharge
  • People who have experienced vaginal bleeding had symptoms persist for:

    • 43% Less Than a Week
    • 35% Less Than a Day
    • 8% One to Two Weeks
  • People who have experienced vaginal bleeding were most often matched with:

    • 75% Polycystic Ovary Syndrome
    • 25% Ovulation Pain (Mittelschmerz) or Midcycle Spotting
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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References

  1. Vaginal Bleeding. U.S. National Library of Medicine: MedlinePlus. Updated July 30, 2018. MedlinePlus Link.
  2. Matteson KA, Mumford S, Schmidt P, Yonkers KA. Your Menstrual Cycle. Office on Women's Health. Updated March 16, 2018. OWH Link.
  3. Barad DH. Vaginal Bleeding. Merck Manual Professional Version. Updated September 2018. Merck Manual Professional Version Link.
  4. Spotting Before a Period. Kimberly-Clark Australia & New Zealand: Huggies. Huggies Link.
  5. Sit A. Mittelschmerz. U.S. National Library of Medicine: MedlinePlus. Updated May 10, 2017. MedlinePlus Link.
  6. Polycystic Ovary Syndrome. U.S. National Library of Medicine: MedlinePlus. Updated August 28, 2018. MedlinePlus Link.
  7. Ectopic Pregnancy. U.S. National Library of Medicine: MedlinePlus. Updated August 23, 2018. MedlinePlus Link.
  8. Jacobson JD. Uterine Fibroids. U.S. National Library of Medicine: MedlinePlus. Updated February 13, 2018. MedlinePlus Link.
  9. Endometriosis. U.S. National Library of Medicine: MedlinePlus. Updated March 13, 2018. MedlinePlus Link.
  10. Nelson AL, Papa RR, Ritchie JJ. Asymptomatic Cervical Polyps: Can We Just Let Them Be? SAGE Journals. Published March 1, 2015. SAGE Journals Link.
  11. Pelvic Inflammatory Disease (PID). Centers for Disease Control and Prevention. Updated July 10, 2017. CDC Link.
  12. Uterine Polyps. Columbia University Medical Center: ColumbiaDoctors. ColumbiaDoctors Link.
  13. Blahd WH, Husney A, Romito K. Abnormal Vaginal Bleeding. University of Michigan: Michigan Medicine. Updated November 20, 2017. Michigan Medicine Link.
  14. Vaginal Bleeding. U.S. National Library of Medicine: MedlinePlus. Updated July 30, 2018. MedlinePlus Link.
  15. Jacobson JD. Abnormal Uterine Bleeding. U.S. National Library of Medicine: MedlinePlus. Updated December 8, 2016. MedlinePlus Link.
  16. Freitas De Medeiros S, Winck Yamamoto MM, Silva Barbosa J. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management. SAGE Journals. Published January 23, 2013. SAGE Journals Link.
  17. Vaginal Bleeding - Irregular. BetterHealth Channel. Updated September 2012. BetterHealth Channel Link.
  18. Vaginal Hysterectomy. Cancer Treatment Centers of America. Cancer Center Link.
  19. Endometrial Ablation. The American College of Obstetricians and Gynecologists. Published July 2017. ACOG Link.
  20. Adenomyosis. The Center for Innovative Gyn Care. CIGC Link.
  21. Burd I. Vaginal Bleeding in Early Pregnancy. U.S. National Library of Medicine: MedlinePlus. Updated November 11, 2016. MedlinePlus Link.
  22. Why Is My Period Late: 8 Possible Reasons. Healthline. Healthline Link.
  23. Stopped or Missed Periods. NHS. Updated July 28, 2016. NHS Link.
  24. Garofalo J. Abnormal Bleeding After Menopause: When To Be Concerned. John M. Garofalo, M.D. John M. Garofalo, M.D. Link.