Sanford Obstetrics & Gynecology

When is vaginal bleeding a medical concern?

Chris Danielson, MD

Any vaginal bleeding unrelated to your menstrual cycle is not normal. Abnormal vaginal bleeding may range from spotting between cycles to heavy bleeding that lasts for weeks. The amount of bleeding isn’t the issue; it’s the fact that the bleeding occurs outside your normal menstrual cycle. Possible causes of abnormal vaginal bleeding range from factors such as use of birth control or hormone replacement therapy to serious illnesses such as cancers of the female organs.

What is considered normal bleeding?

Menstruation, which occurs every 21 to 35 days, signals the start of another reproductive cycle. What is considered normal varies among women and your personal history determines what is normal for you. Some women have light menstrual periods for only a few days while other women may have a cycle that lasts more than a week with heavy flow. What is not normal is when you bleed outside the time frame of your menstrual cycle.

Are women more likely at certain times to have unexplained vaginal bleeding?

Over the course of their lifetime, many women experience unexpected vaginal bleeding at some point. In newborn baby girls, some vaginal bleeding may occur within the first week of life. This isn’t a concern. In adolescent girls, and even in many adult women, spotting is common for a few days before and after menstruation. Women who begin taking birth control pills may also have sporadic spotting within the first few months. Some women of childbearing age have light spotting during ovulation. As women approach menopause, they often have heavier or more irregular periods. Postmenopausal women who are using hormone therapy such as estrogen and/or progestin may experience some break-through bleeding.

When does abnormal bleeding warrant a doctor’s appointment?

If you are pregnant or trying to get pregnant, call your OB/GYN immediately and tell him/her if you are bleeding. Vaginal bleeding can be symptomatic of miscarriage or ectopic pregnancy. If you just had a baby or an abortion, you also need to immediately contact your doctor. You could have fetal tissue that remains in the uterus. In other instances, young girls who aren’t yet menstruating or women approaching menopausal age who experience heavy bleeding should make appointments immediately. Also, if you are an older woman who has not had a menstrual cycle for 12 months and you begin bleeding, you should have it investigated. Even if you are not in the above populations but you have abnormal bleeding for more than two weeks or excessively heavy bleeding, make an appointment with an OB/GYN.

What can an OB/GYN do to treat vaginal bleeding?

In addition to possible causes already mentioned, other potential problems related to vaginal bleeding include hypothyroidism, cysts, polyps, uterine fibroids, pelvic inflammatory disease, medication side effects, blood clotting disorders and other serious conditions that require medical treatment. An OB/GYN will first determine the cause of your bleeding and treat that cause, which will alleviate the bleeding.

Chris Danielson, MD is a board-certified obstetrician & gynecologist at Sanford Obstetrics & Gynecology. For an appointment, call (701) 323-8262 or click here to request an appointment online.