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Many women experience abnormal vaginal
bleeding or spotting between periods sometime in their lives. Vaginal bleeding
is considered to be
abnormal if it occurs:
Abnormal vaginal bleeding has many possible causes. By itself, it does not necessarily indicate
a serious condition.
Other less common causes of abnormal vaginal bleeding that
may be more serious include:
Heavy bleeding during the first few weeks after delivery
(postpartum) or after an abortion may occur because the uterus has not
contracted to the prepregnancy size or because fetal tissue remains in the
uterus (retained products of conception).
If you are age 40 or
older, abnormal vaginal bleeding may mean that you are entering
perimenopause. In a woman who has not had a menstrual
period for 12 months, vaginal bleeding is always abnormal and should be
discussed with your doctor.
Treatment of abnormal vaginal bleeding
depends on the cause of the bleeding.
Check your symptoms to decide if and when you should see a doctor.
Based on your answers, you need
Call911or other emergency services now.
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through
their usual pads or tampons every hour for 2 or more hours is not normal and is
considered severe. If you are pregnant: You may have
a gush of blood or pass a clot, but if the bleeding stops, it is not considered
Moderate bleeding means that you
are soaking more than 1 pad or tampon in 3 hours.
Mild bleeding means that you are soaking less than 1 pad or
tampon in more than 3 hours.
Minimal vaginal bleeding means "spotting" or a few drops of blood.
Pain in adults and older children
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Based on your answers, the problem may not improve without medical
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Many prescription and nonprescription medicines can cause
changes in vaginal bleeding. A few examples are:
There is no home treatment for
abnormal vaginal bleeding. With some types of vaginal bleeding, it may be okay
to wait to see if the bleeding stops on its own. Check your symptoms to decide if and when you should see a doctor. If the
bleeding continues or gets worse, see your doctor to find out
the reason for the bleeding.
If you are using tampons for abnormal
vaginal bleeding, be sure to change them often, and do not leave one in place
when the bleeding has stopped. A tampon left in the vagina may put you at risk
toxic shock syndrome (TSS). TSS is a rare but
life-threatening illness that develops suddenly after a bacterial infection
rapidly affects several different organ systems.
If you are age 40
or older, you may be experiencing
perimenopause. For more information, see the topic
Menopause and Perimenopause.
Call your doctor if any of the following occur during home
You may be able to prevent abnormal
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
November 3, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine
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