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Vaginal Bleeding

vaginal-bleeding
By Medicover Hospitals / 12 Jan 2021
Home | symptoms | vaginal-bleeding
  • Vaginal bleeding or abnormal uterine bleeding (AUB) is bleeding from the uterus that is longer than usual or occurs at an irregular time. The bleeding may be heavier or lighter than usual and occur frequently or randomly. The term dysfunctional uterine bleeding was used when there was no underlying cause.
  • Article Context:

    1. What is vaginal bleeding or Abnormal Uterine Bleeding (AUB)?
    2. Causes
    3. Diagnosis
    4. Treatment
    5. Complications
    6. When to see a Doctor?
    7. Home Remedies
    8. FAQ's

    What is vaginal bleeding or Abnormal Uterine Bleeding (AUB)?

  • Abnormal Uterine Bleeding (AUB) is a disorder of the menstrual cycle. Abnormal vaginal bleeding between periods is also called breakthrough bleeding, spotting, and metrorrhagia. Any change in the amount or length of your period is also considered abnormal uterine bleeding. AUB can be from a random day of mild spotting to ten days of heavy bleeding that replaces your regular menstrual flow.
  • Causes:

  • Normal vaginal bleeding, also known as your period, can occur for a few days to a week. Any bleeding outside of that is considered unusual and can be due to numerous factors. There are some possible causes behind abnormal uterine bleeding. Some causes may include:
  • Chormonal imbalance:

  • Estrogen and progesterone are the 2 hormones that can regulate your cycle and any disturbance in them can affect your hormonal balance:
    • dysfunctional ovaries
    • thyroid gland problems
    • start or stop birth control pills

    Complications of pregnancy:

  • Complications during pregnancy can cause spotting miscarriage and ectopic pregnancy can cause bleeding. An ectopic pregnancy occurs when a fertilized egg implants itself in the fallopian tube in place of the uterus. Spotting during pregnancy may not mean that you are having a miscarriage.
  • Uterine fibroids:

  • Uterine fibroids are non-cancerous growth that usually forms in the uterus and they are very common in women who have given birth.
  • Infection:

  • Vaginal bleeding between periods may imply infection of your reproductive organs. The infection can cause inflammation and bleeding that includes:
    • sexually transmitted infection
    • douching
    • intercourse
    • pelvic inflammatory disease, which is characterized by inflammation of the reproductive organs leading to scar formation.

    Cancer:

  • Bleeding can cause:
    • cervix
    • vagina
    • uterus
    • ovaries

    Other rare causes can be:

    • inserting an object into the vagina
    • extreme stress
    • diabetes
    • thyroid disorders
    • significant weight gain or loss

    Diagnosis:

  • When you visit a doctor, a physical exam is also done. A complete blood count can help doctors estimate how much blood has been lost and if there is anemia. A pregnancy test is also done.
    • A blood test is done to check the level of iron in the body. The test can see if that is a problem for you. It also can show if hormones are out of balance or when you have a blood disorder or chronic disease.
    • Ultrasound uses sound waves to create pictures of the inside of your uterus so your doctor can look for fibroids or polyps.
    • The doctor uses a hysteroscopy to look inside the uterus with a small lighted scope that is placed through your cervix.
    • The doctor can remove a small piece of tissue and examine it under a microscope for abnormal cells using the biopsy.
    • MRI imaging uses radio waves and strong magnets to create detailed images of the uterus. It is not used as often, but it can help detect adenomyosis.
    • Your doctor will likely also perform a physical exam, including a pelvic exam.
  • Therefore, the diagnosis will help you and the doctor to find the real cause of excessive vaginal bleeding.
  • Treatment:

  • Treatment will depend on the cause of the abnormal uterine bleeding - if a chronic disease or blood disorder is at the root of your symptoms, treatment can help and can also help:
    • How old is the woman?
    • How heavy the bleeding is?
    • If the lining of the uterus is thickened
    • If the lining of the uterus is thickened
  • Medications are usually the first thing your doctor will try. They include:
    • Hormones Birth control pills and other hormonal treatments can give you regular menstrual cycles and lighter periods.
    • Gonadotropin-releasing hormone (GnRHa) agonists prevent your body from producing certain hormones. They can shrink fibroids for a time but are usually used in conjunction with other treatments.
    • By taking NSAIDs and anti-inflammatories like ibuprofen or naproxen a few days before your period starts, they can help relieve bleeding.
    • Tranexamic acid is a pill that helps blood clot and can control heavy uterine bleeding.
    • IUD prevents the release of a hormone called progestin that can stop heavy bleeding. Many women who use one do not have a period at all.
    • In some severe cases, a surgical procedure may be necessary to stop the bleeding.
    • Endometrial ablation uses heat, cold, electricity, or a laser to destroy the lining of the uterus. You may end your periods completely and there will probably be no chance of pregnancy after it has been done. You will need to use birth control until menopause.
    • A myomectomy or uterine artery embolization will be performed. If you have fibroids, your doctor can remove them or cut the vessels that supply them with blood.
    • A hysterectomy is performed when the doctor removes your uterus. You may need a hysterectomy if your fibroids are very large, or if you have cancer of the endometrium or uterus. Otherwise, it is the last resort when other treatments have not worked.

    Complications:

  • There may be some complications that can occur with abnormal uterine bleeding including:
    • Problems getting pregnant
    • Anemia or blood loss
    • Increased risk of endometrial cancer

    When to see a Doctor?

  • The cause of the bleeding can be serious and must be determined. You should see your doctor immediately if you are pregnant and have vaginal bleeding.
  • If you have other severe symptoms in addition to bleeding, you may need emergency medical attention. These include:
    • pain
    • fatigue
    • dizziness
    • fever
    • must double protection to provide adequate coverage
    • soaks one or more sanitary pads or tampons per hour
    • you have to change your sanitary pad or tampon overnight
    • expels blood clots larger than a quarter
    • have symptoms of anemia, such as fatigue, shortness of breath, and pale skin
    • your periods last more than a week at a time
  • Most causes of heavy periods, such as fibroids, are more uncomfortable than serious. But if you don't treat the problem and you bleed a lot, you could develop anemia. Your doctor will work with you to create a plan of care that is tailored to your needs while alleviating your symptoms. This may take a bit of trial and error, so be open with your doctor and give him time.
  • Home Remedies

    Hydrate:

  • If you bleed a lot for a few days, your blood volume may drop too low. Drinking an additional 4 to 6 cups of water a day can help maintain blood volume.
  • Drink an electrolyte solution like Gatorade or add more salt to your diet to balance the excess fluid you are drinking.
  • Eat foods rich in vitamin C:

  • This vitamin helps the body in absorbing iron the prevents anemia. You will find it in citrus fruits and veggies like:
    • oranges
    • grapefruits
    • red and green peppers
    • kiwis
    • strawberries
    • brussels sprouts
    • broccoli
    • tomato juice

    Iron-rich foods in your diet:

  • When you bleed, you lose iron. Your body needs iron to make hemoglobin, a molecule that helps red blood cells carry oxygen. Heavy periods can deplete the iron in the body and cause iron-deficiency anemia.
    • lean meat
    • oysters
    • chicken and turkey
    • beans
    • tofu
    • spinach

    Cook in a cast iron pot:

  • Another way to increase your iron intake is to cook in a cast-iron skillet. Foods with high moisture, such as spaghetti sauce, absorb the most iron
  • Stirring the pot frequently will attract even more iron to the food.
  • Frequently Asked Questions:

  • Stress can cause spotting between periods, also a common cause of late or skipped menstrual periods.
  • This abnormal uterine bleeding (AUB) could have several causes, however, while AUB is related to changes in hormones that have a direct effect on the menstruation cycle, this circumstance is known as dysfunctional uterine bleeding.
  • Hematometry is a medical condition that involves the collection or retention of blood in the uterus. It is most commonly caused by an imperforate hymen or a transverse vaginal septum.
  • Citations:

  • The analysis of vaginal bleeding patterns induced by fertility regulating methods - https://www.sciencedirect.com/science/article/abs/pii/0010782486900065
  • Vaginal Bleeding during Pregnancy and Preterm Birth - https://academic.oup.com/aje/article/160/2/118/76343
  • Gestational Vaginal Bleeding and Pregnancy Outcome - https://academic.oup.com/aje/article-abstract/129/4/806/88076