Abnormal vaginal bleeding

Any vaginal bleeding that occurs outside of regular menstrual bleeding is considered abnormal vaginal bleeding.

According to research, about a third of women experience abnormal vaginal bleeding at some point in their lives. It is one of the most common gynecological problems that can have many causes.

A normal menstrual cycle lasts an average of 28 days, while menstrual bleeding lasts 2 to 7 days. Blood loss of up to 80ml during a regular cycle is normal.

If there is a variation in any of the above parameters, we speak of abnormal vaginal bleeding.

Whenever bleeding occurs between periods, it is necessary to perform an examination by a gynecologist.

Although mild, spotting between regular menstrual bleeding does not have to be a medical emergency, it is certainly necessary to check what caused this situation.

It is not uncommon for mild bleeding between periods to occur in young girls in the period immediately after getting their first menstrual period.

In addition to bleeding between periods, abnormal vaginal bleeding also includes prolonged, heavy or too frequent menstruation and postmenopausal bleeding.

In the period approaching menopause (perimenopause), the occurrence of abnormal vaginal bleeding is also possible. In the time before menopause, ovulation is no longer regular, hormonal imbalance occurs, and because of this, changes in the rhythm of bleeding can occur.

Changing oral contraceptives or skipping oral contraceptives can also cause abnormal vaginal bleeding. However, the causes can also be sexually transmitted diseases, spontaneous abortion or benign and malignant tumors.

Even when bleeding is not heavy or accompanied by other symptoms such as pain, any occurrence is a sign that there is some kind of disorder in the body.

It is for this reason that any abnormal vaginal bleeding requires a visit to the gynecologist.

Most abnormal vaginal bleeding is related to hormonal imbalances. The key hormones in the regulation of the normal menstrual cycle are progesterone and estrogen.

These sex hormones act on the reproductive organs and are interdependent. If an excessive amount of progesterone or estrogen is produced or a deficiency occurs, the menstrual cycle is disrupted.

In addition to hormonal imbalance, abnormal vaginal bleeding can be caused by inflammatory diseases of the reproductive organs, tumors, but also systemic diseases.

Irregular, heavy and very painful menstruation can be a sign of a systemic disease or uterine tumor.

The regulation of the menstrual cycle takes place through the complex, interdependent action of sex hormones. The average duration of the menstrual cycle is 28 days, or a minimum of 21 days and a maximum of 35 days.

Changes in the balance of estrogen and progesterone can also lead to bleeding between periods. The appearance of spotting hemorrhages caused by disturbances in estrogen secretion is characteristic in the premenopausal period.

In addition to sex hormones, abnormal bleeding can also be caused by thyroid hormones. Decreased or increased secretion of the hormones thyroxine (T4) and triiodothyronine (T3) can cause changes in the menstrual cycle and abnormal vaginal bleeding.

Thyroid hormones affect all metabolic processes in the body, bleeding outside the menstrual period can be accompanied by additional symptoms such as sudden weight change, weakness, brittle hair, nails and the like.

Polycystic ovary syndrome is a relatively common gynecological problem in women of reproductive age. About 10% of women between the ages of 15 and 45 suffer from this disorder.

It is caused by hormonal imbalances that predominantly arise as a result of a combination of genetic and environmental factors.

One of the most common symptoms of polycystic ovary syndrome is irregular periods and heavy and painful bleeding when menstruation occurs.

Due to the irregular menstrual cycle, patients with polycystic ovary syndrome often suffer from the inability to conceive.

According to the World Health Organization, polycystic ovary syndrome is one of the leading causes of infertility.

Polycystic ovary syndrome should be suspected, especially if abnormal vaginal bleeding is accompanied by additional symptoms such as weight gain, increased hairiness, acne and oily skin.

Bleeding in pregnancy can occur at any time, but it most often occurs in the first trimester. Depending on the amount of bleeding and the stage of pregnancy in which it occurs, it can pose a smaller or greater risk to the mother and baby.

Bleeding in pregnancy can occur as a result of complications of the pregnancy itself or due to other problems that are not related to pregnancy.

Bleeding in the first trimester of pregnancy occurs in about 75% of all pregnancies, that is, relatively often.

Light or spotting bleeding can occur when a fertilized egg is implanted in the uterine wall, so-called implantation bleeding.

Implantation bleeding occurs between the 6th and 10th day after fertilization and can be one of the early signs of pregnancy. It is characterized by the appearance of several drops of blood of pink or red color on underwear or sanitary napkin.

Some women can clearly distinguish this type of bleeding from normal menstruation. However, in any case, in the event of any abnormal bleeding, it is necessary to seek the advice of a gynecologist.

Abnormal vaginal bleeding can also occur in the case of spontaneous abortion. It is characterized by the appearance of mild bleeding that becomes more abundant with pain in the lower abdomen and back.

The occurrence of such vaginal bleeding is an emergency condition and it is necessary to seek medical help immediately.

Ectopic pregnancy is another possible cause of abnormal vaginal bleeding in pregnancy.

It is a pregnancy during which the fertilized egg, instead of on the uterine mucosa, is implanted in another organ (fallopian tube, ovary, abdominal cavity, cervix). Bleeding is usually accompanied by a one-sided, sharp pain in the lower abdomen.

Ectopic pregnancy is a life-threatening condition for a woman and the 3rd cause of mortality in pregnant women.

Treatment in case of abnormal vaginal bleeding aimed at searching for the cause.

The first procedure when treating a patient is certainly taking a medical history.

During a gynecological examination, the doctor will ask you for information about the frequency, duration and amount of bleeding, the date of the last menstrual period, menarche (first menstrual period), the medications you use, etc. If you are taking hormonal contraception, you should definitely emphasize this to your gynecologist.

A gynecological examination can determine changes in the vagina, uterus or cervix, and the physical examination is supplemented by a gynecological ultrasound.

In women of childbearing age, a possible pregnancy is first ruled out by a urine pregnancy test.

Therapeutic procedures in the case of abnormal vaginal bleeding can be different, depending on the cause.

For example, if the cause is a hormonal imbalance, appropriate hormone therapy is administered. Treatment of other causes is selected according to the results of additional tests.

Gynecology Outpatient Clinic Lohuis Filipović Polyclinic provides medical care through collaborative and teamwork that unites experience, knowledge and cutting-edge technology to respond to the specific needs of each patient.

Our goal is successful diagnosis, treatment, patient monitoring, and positive and long-term results.

Our multidisciplinary team brings together renowned experts with many years of experience in scientific and practical work.