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Causes
By Mayo Clinic staffAbnormal vaginal bleeding can relate to an issue with your reproductive system (a gynecologic condition) or to other medical problems or certain medications. If you've gone through the menopausal transition — 12 consecutive months without a menstrual period — any vaginal bleeding is a particular cause for concern.
Possible causes of abnormal vaginal bleeding include:
- Adenomyosis
- Celiac disease
- Cervical cancer
- Cervicitis
- Chlamydia
- Ectopic pregnancy
- Endometrial cancer
- Endometrial hyperplasia
- Endrometrial polyps
- Endometritis
- Fluctuating hormone levels
- Gonorrhea
- Hypothyroidism (underactive thyroid)
- Hyperthyroidism (overactive thyroid)
- Intrauterine contraceptive device
- Menorrhagia (heavy menstrual bleeding)
- Miscarriage
- Ovarian cancer
- Ovarian cysts
- Pelvic inflammatory disease (PID)
- Perimenopause
- Polycystic ovary syndrome
- Pregnancy
- Random ovulatory cycles
- Severe systemic disease, such as kidney or liver disease
- Sexual abuse
- Sexual intercourse
- Stopping birth control pills or hormone replacement therapy (withdrawal bleeding)
- Tamoxifen side effect
- Thrombocytopenia (low platelet count)
- Uterine fibroids
- Uterine polyps
- Uterine sarcoma
- Vaginal atrophy
- Vaginal cancer
- Vaginal or cervical trauma
- Vaginitis
- Von Willebrand disease (and other blood clotting disorders)
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.
References
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 128. Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstetrics and Gynecology. 2012;120:197.
- South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=52. Accessed Mar. 4, 2013.
- Schmitz G, et al. Genitourinary emergencies in the nonpregnant woman. Emergency Medicine Clinics of North America. 2011:29;621.
- Goodman AK. Initial approach to the premenopausal woman with abnormal uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.
- AskMayoExpert. What are the most common causes of abnormal uterine bleeding? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. What are the most common causes of postmenopausal vaginal bleeding? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Casper RF. Clinical manifestations and diagnosis of menopause. http://www.uptodate.com/home. Accessed March 10, 2013.
- Goodman AK. Postmenopausal uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.
- Zacur HA. Managing an episode of severe or prolonged uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed March 5, 2013.
- Tsai MC, et al. Office diagnosis and management of abnormal uterine bleeding. Clinical Obstetrics and Gynecology. 2012;55:635.
- Paradise J. Evaluation of vaginal bleeding in children and adolescents. http://www.uptodate.com/home. Accessed March 12, 2013.
- Hickey M, et al. Unscheduled bleeding in continuous combined hormone therapy users. Maturitas. 2011;70:400.
- Fritz MA, et al., eds. Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=booktext&D=books&AN=01437507$&XPATH=/PG(0). Accessed March 12, 2013.
- Goodman AK. Overview of causes of genital tract bleeding in women. http://www.uptodate.com/home. Accessed March 22, 2013.
- Frequently asked questions. Gynecologic problems FAQ162. Perimenopausal bleeding and bleeding after menopause. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq162.pdf?dmc=1&ts=20130329T1216499168. Accessed March 22, 2013.
- General information about vaginal cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/vaginal/Patient/page1. Accessed March 21, 2013.
- Shah SH, et al. Uterine sarcomas: Then and now. American Journal of Roentgenology. 2012;199:213.
- Gonorrhea - CDC Fact Sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm. Accessed March 21, 2013.
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