Vaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different.
Most women have cycles between 24 and 34 days apart. It usually lasts 4 to 7 days.
Young girls may get their periods anywhere from 21 to 45 days or more apart.
Women in their 40s will often notice their period occurring less often.
Many women have abnormal bleeding between their periods at some point in their lives. Abnormal bleeding occurs when you have:
Heavier bleeding than usual
Bleeding for more days than normal (menorrhagia)
Spotting or bleeding between periods
Bleeding after sex
Bleeding after menopause
Bleeding while pregnant
Bleeding before age 9
Menstrual cycles longer than 35 days or shorter than 21 days
No period for 3 to 6 months (amenorrhea)
Irregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding
There are many causes of abnormal vaginal bleeding.
Most often, abnormal uterine bleeding is caused by a hormone imbalance. When hormones are the cause, doctors call the problem dysfunctional uterine bleeding (DUB). DUB is more common in teenagers or in women who are approaching menopause.
It is not always clear what causes hormone changes that lead to DUB. Hormone changes may be due to:
Menopause or perimenopause
Changes in birth control pills or hormone medicines
Treatment may include hormonal medicines, pain relievers, and possibly surgery.
The type of hormone you take will depend on whether you want to get pregnant as well as your age.
Birth control pills can help make your periods more regular.
Hormones also can be given as an injection, as a vaginal cream, or through an IUD that releases hormones.
An IUD is a birth control device that is inserted in the uterus. The hormones in the IUD are released slowly and may control abnormal bleeding.
Other medications given for abnormal uterine bleeding may include:
Nnonsteroidal anti-inflammatory drugs (ibuprofen or naproxen) to help control bleeding and reduce menstrual cramps
Tranexamic acid to help treat heavy menstrual bleeding
Antibiotics to treat infections
When to Contact a Medical Professional
Call your doctor if:
You have soaked through a pad or tampon every hour for 2 to 3 hours.
Your bleeding lasts longer than 1 week.
You have vaginal bleeding and you are pregnant or could be pregnant.
You have severe pain, especially if you also have pain when not menstruating.
Your periods have been heavy or prolonged for three or more cycles, compared to what is normal for you.
You have bleeding or spotting after reaching menopause.
You have bleeding or spotting between periods or caused by having sex.
Abnormal bleeding returns.
Bleeding increases or becomes severe enough to cause weakness or lightheadedness.
You have fever or pain in the lower abdomen
Your symptoms become more severe or frequent.
Aspirin may prolong bleeding and should be avoided if you have bleeding problems. Ibuprofen is usually works better than aspirin for relieving menstrual cramps. It also may reduce the amount of blood you lose during a period.
ACOG Practice Bulletin No. 110: Noncontraceptive uses of hormonal contraceptives. Obstet Gynecol. 2010 Jan;115(1):206-18. PMID: 20027071. Available at: www.ncbi.nlm.nih.gov/pubmed/20027071.
Marjoribanks J, Proctor M, Farquhar C, Derks RS. Nonsteroidal anti-inflammatory drugs for dysmenorrhoea. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001751. PMID: 20091521. Available at: www.ncbi.nlm.nih.gov/pubmed/20091521.
Irina Burd, MD, PhD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.