Medicines, such as
birth control pills, sometimes cause abnormal vaginal bleeding. You may have
minor bleeding between periods during the first few months if you have recently
started using birth control pills. You also may have bleeding if you do not
take your pills at a regular time each day. For more information, see the topic
Infection of the
pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause
vaginal bleeding, especially after intercourse or douching. Sexually
transmitted infections (STIs) are often the cause of infections. For more
information, see the topic
Sexually Transmitted Infections.
Heavy bleeding during the first few weeks after delivery
(postpartum) or after an abortion may occur because the uterus has not
contracted to the prepregnancy size or because fetal tissue remains in the
uterus (retained products of conception).
If you are age 40 or
older, abnormal vaginal bleeding may mean that you are entering
perimenopause. In a woman who has not had a menstrual
period for 12 months, vaginal bleeding is always abnormal and should be
discussed with your doctor.
Treatment of abnormal vaginal bleeding
depends on the cause of the bleeding.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don't have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
Pain in adults and older children
Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
Feeling very dizzy or
lightheaded, like you may pass out.
Feeling very weak or having
Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Make an Appointment
Based on your answers, the problem may not improve without medical
Make an appointment to see your doctor in the
next 1 to 2 weeks.
If appropriate, try home treatment while you
are waiting for the appointment.
If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Many prescription and nonprescription medicines can cause
changes in vaginal bleeding. A few examples are:
Anticoagulant medicines used to prevent blood
clots, such as warfarin (Coumadin) and aspirin.
such as prednisone.
Missed or Irregular Periods
Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through
their usual pads or tampons every hour for 2 or more hours is not normal and is
considered severe. If you are pregnant: You may have
a gush of blood or pass a clot, but if the bleeding stops, it is not considered
Moderate bleeding means that you
are soaking more than 1 pad or tampon in 3 hours.
Mild bleeding means that you are soaking less than 1 pad or
tampon in more than 3 hours.
Minimal vaginal bleeding means "spotting" or a few drops of blood.
There is no home treatment for
abnormal vaginal bleeding. With some types of vaginal bleeding, it may be okay
to wait to see if the bleeding stops on its own. Check your symptoms to decide if and when you should see a doctor. If the
bleeding continues or gets worse, see your doctor to find out
the reason for the bleeding.
If you are using tampons for abnormal
vaginal bleeding, be sure to change them often, and do not leave one in place
when the bleeding has stopped. A tampon left in the vagina may put you at risk
toxic shock syndrome (TSS). TSS is a rare but
life-threatening illness that develops suddenly after a bacterial infection
rapidly affects several different organ systems.
You may be able to prevent abnormal
Maintain a healthy weight. Women who are
overweight or underweight have more problems with abnormal vaginal bleeding. For more information, see the topic
If you are using birth
control pills, be sure to take them as directed and at the same time every day.
For more information, see the topic
If you are taking
hormone therapy, take your pills as
directed and at the same time every month.
Learn to practice
relaxation exercises to reduce and cope with stress. Stress may cause abnormal
vaginal bleeding. For more information, see the topic
nonsteroidal anti-inflammatory drug (NSAID), such as
naproxen or ibuprofen. NSAIDs reduce menstrual bleeding by decreasing the
production of substances called prostaglandins. The usual recommended dose of
ibuprofen is 400 mg every 6 hours. Begin taking the medicine on the first day
of your period and continue taking it until your menstrual bleeding stops. Be
sure to follow these nonprescription medicine precautions.
Carefully read and follow all label
directions on the medicine bottle and box.
Use, but do not exceed,
the maximum recommended doses.
How this information was developed to help you make better health decisions.