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Understanding Abnormal Vaginal Bleeding: Causes, Diagnosis, and Treatment Options

Updated: Jun 28

The average cycle ranges from 21 and 35 days, with periods lasting for a few days to a week. Any bleeding out of this timeframe is considered as unusual and can be caused by various factors. 


Hormonal imbalances 

Bleeding during ovulation is due to hormonal changes. It may happen if hormones (Estrogen and progesterone) are not balanced. Hormone imbalance may also come from birth control pills or other hormonal contraceptives, polycystic ovary syndrome (PCOS), thyroid gland problems, hormone replacement therapy, and dysfunctional ovaries. In some cases, stress can influence an individual's hormone levels and lead to abnormal vaginal bleeding.



Medical conditions

Medical conditions such as uterine fibroids, cervical or endometrial polyps, endometrial hyperplasia, severe cervicitis, cancers in cervix, endometrium, ovaries or fallopian tubes, and other medical conditions. 


Other causes and pregnancy complications 

Other causes may include birth control devices, a recent abortion, injury, harmless changes of the cervix like cervical erosion, cervical/ endometrial biopsies, and infection like chlamydia, or other infection of the reproductive organs.



Pregnancy complications such as a miscarriage and an ectopic pregnancy (fertilized egg out of the uterus) can cause abnormal vaginal bleeding, please talk to your healthcare provider once you are pregnant and detect vaginal bleeding.


Diagnosis

Your healthcare provider will inquire about your symptoms and medical history. They will perform a physical exam and pelvic exam , and may also order several tests to detect the causes of bleeding, including a Pap test or HPV  test, blood tests, urinalysis, pregnancy test, ultrasound, hysteroscopy and other tests based on your specific situation. 

 

Treatment 

There are various treatment options available. The hormone therapy can involve hormonal birth control and other medicines. Hysteroscopy can be utilized to remove fibroids and polyps. If other treatments are ineffective, a hysterectomy may be considered. 


References 

 

1 NHS. 2023. What causes bleeding between periods?

 

2 Mary Ellen Ellis. 2023. Vaginal Bleeding Between Periods. 

 

3 Cleveland Clinic. 2022. Vaginal Bleeding.

 

4 HealthLinkBc. N.D. Abnormal Uterine Bleeding.

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