Vaginal Bleeding

Vaginal bleeding is the presence of bright red blood from the vagina. This is normal in women of childbearing age who haven't experienced menopause. Menopause is the stoppage of the monthly "period" cycle. It is common for women taking chemotherapy to experience irregular menstrual periods. However, abnormal bleeding should be reported to your health care provider. Women who are on chemotherapy may experience low blood platelets. This may cause excessive vaginal bleeding.

Causes of Vaginal Bleeding Problems (Pre-Menopause):

Women who are still experiencing their periods, and have bleeding in between their normal menses may have vaginal bleeding problems due to: 

• Pregnancy
• Medications - such as birth control pills (oral contraceptives), steroids, blood thinners (such as Enoxaparin or Warfarin).
• Trauma - from tampon use, intrauterine devices (IUD's - to prevent pregnancy) or a foreign body.
• Diseases - such as a blood clotting disorder, thyroid, kidney or liver disease.
• Stress, exercise, diet and nutritional state.

Causes of Vaginal Bleeding Problems (Post-Menopausal):

Women who have experienced the stoppage of their menses may have vaginal bleeding problems due to:

• Hormone replacement therapy (HRT)
• Cancer - of the cervix or endometrium. Certain hormones and medications used to treat breast cancer may have vaginal bleeding problems as a side effect.
• Medications - such as steroids, blood thinners (such as Enoxaparin or Warfarin)
• Trauma - from a foreign body.
• Diseases - such as a blood clotting disorder, thyroid, kidney or liver disease
• Stress, exercise, diet and nutritional state

Remember: People who bruise or begin bleeding easily may have problems with how their blood clots, and have a tendency to bleed easily as well. If you notice that you are bruising or bleeding easily, notify your health care provider of potential bleeding problems.

• To diagnose your vaginal bleeding, your health care provider may order some blood tests such as:
• Complete Blood Count (CBC)
• Blood clotting times (including your PT, PTT)
• Thyroid function (TSH)
• You may require a pelvic examination and PAP smear
• Your health care provider may order other tests, including a pregnancy test for women of childbearing age, or other hormone levels, if appropriate.

Symptoms of Vaginal Bleeding Problems:

• You may notice bright red blood from your vagina.  
• Vaginal bleeding problems are usually not painful, but you may experience abdominal discomfort. 
• You may be overly tired, or very weak (fatigue), due to anemia. It may be hard for you to do your normal activities.
• You may have tiny red dots on your skin, called petechiae (pe- TEEK- ee- ay). These are commonly found on your lower legs. This may be a sign of low blood platelets.
• You may have frequent nosebleeds if you have low blood platelets, or a blood clotting disorder. 

Things You Can Do To Manage Vaginal Bleeding Problems:

• Especially if you have a bleeding disorder, or a form of cancer, notify your health care provider immediately if you experience unexplained vaginal bleeding. 
• Do not use tampons, or place anything into the vagina if you have low blood counts, and are prone to infection. It is important to minimize trauma or damage to the tissues in the area. 
• If you have pain, you may take Acetaminophen (Tylenol®) up to 4000 mg per day (two extra-strength tablets every 6 hours). As with all medications, you should check with your health care provider before you take any medications.
• If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, or accentuate your bleeding problems.  
• Make sure you tell your doctor, as well as all health care providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). Do not take aspirin or products containing aspirin unless your health care provider permits this. 

Drugs/Recommendations That May Be Prescribed by Your Doctor:

Treatment of vaginal bleeding problems includes identifying and treating the cause.

• If your bleeding problems are due to low blood platelets or blood clotting problem, your doctor may recommend medication or a platelet transfusion.
• Antibiotics - to treat infection.
• If your bleeding problems are due to HRT (which usually contains estrogen and progesterone if you have not had a hysterectomy [removal of your uterus]), your health care provider may switch your medications to another form or discontinue hormone replacement therapy. A different brand or formulation of the hormones may eliminate bleeding problems. 
• If your bleeding problems are due to other medications, your health care provider may adjust them.
• If you have a bleeding disorder, you should avoid non-steroidal anti-inflammatory (NSAID) drugs, as well as aspirin, because these drugs may interfere with blood platelets, and accentuate bleeding problems. 

When to Contact Your Doctor or Health Care Provider:

• Prolonged vaginal bleeding, increased amounts of bleeding, after you have talked with your health care provider.
• Any new rashes on your skin, especially if you have been taking a new medication.
• If you notice that you are bruising or bleeding easily, notify your health care provider of potential bleeding problems.

Other Common Bleeding Problems:

Bruising (Hematoma) | Injury | Nosebleeds (Epistaxis) | Rectal Bleeding | Vaginal Bleeding

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about bleeding problems and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.