Vaginal bleeding, also known as “vaginal hemorrhage,” refers to the condition characterized by the discharge of blood from the uterus, cervix, or vagina itself.
Abnormal vaginal bleeding can be attributed to gynecological conditions or other medical issues, including the use of certain medications. Therefore, it is recommended to undergo a gynecological examination when experiencing this symptom to understand the underlying causes and receive appropriate guidance. If the symptom occurs during pregnancy, it is advisable to seek immediate medical attention at the emergency room.
The Causes of Vaginal Bleeding
Abnormal vaginal bleeding can have various causes. Some possible factors contributing to this condition include:
- Endocrine system factors, such as thyroid dysfunction (hyperthyroidism or hypothyroidism), hyperprolactinemia, polycystic ovary syndrome (PCOS), and discontinuation or changes in birth control pills or hormone therapy during menopause. It is not uncommon to experience minor blood losses during the initial months of starting a new hormonal contraceptive.
- Ovulation-related hormonal changes, as hormonal fluctuations during ovulation can cause periovulatory spotting.
- Benign gynecological conditions, such as cervical polyps, endometrial polyps, uterine fibroids, and ovarian cysts.
- Trauma or bruising, for example, resulting from sexual intercourse. This is more common in postmenopausal women due to tissue atrophy. Some women may have fragile cervical tissue, which can lead to bleeding after intercourse or following a pap smear.
- Infections, such as cervicitis – caused by chlamydia or gonococcus – vaginitis, endometritis – the inflammation of the uterine cavity – and pelvic inflammatory disease (PID).
- Factors related to pregnancy, such as miscarriage, ectopic pregnancy, and implantation bleeding in early pregnancy – which does not necessarily indicate a problem.
- Placental pathologies. Vaginal bleeding during the second and third trimesters of pregnancy could be related to conditions like placenta previa and placental abruption. In such cases, urgent specialist evaluation is required.
- Various medical conditions, such as celiac disease, severe systemic diseases – affecting the kidney or liver – thrombocytopenia – a low platelet count – Von Willebrand disease, and other blood clotting disorders.
- Drug use or devices, especially antiplatelet drugs like aspirin and anticoagulants, intrauterine devices (IUDs), and forgotten tampons left inside the vagina.
Abnormal bleeding, especially during peri- and postmenopause, should always be evaluated by a specialist to rule out benign or potentially more organic severe pathologies such as:
- Endometrial hyperplasia
- Cervical cancer
- Uterine cancer
- Ovarian cancer
- Uterine sarcomas
- Vulvo-vaginal carcinomas
The Importance of Gynecological Examination for Vaginal Bleeding
Due to the diverse range of possible causes for abnormal vaginal bleeding, it is essential to consult a gynecologist if experiencing such symptoms. A gynecological examination will help determine the nature of the bleeding and guide appropriate action.
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