Abnormal bleeding from the vagina that is not part of the monthly period or bleeding during the period that is heavier than usual. In women of reproductive age, causes can include the use of birth control pills; problems with hormones produced by the ovaries or thyroid, pituitary, or adrenal glands; infections of the vagina, cervix, uterus, fallopian tubes, or ovaries, including sexually transmitted diseases; ectopic pregnancies; and miscarriage. Bleeding can also be caused by scars, tumors, fibroids, or other abnormal tissue on the uterus or cervix; cysts on the ovaries; or growths in the endometrium (the lining of the uterus).
Vaginal bleeding can stem from various sources, including the uterus, the cervix—which is the neck of the uterus—or the vaginal canal itself.
The uterus is the most frequent origin of vaginal bleeding, with menstruation being the most common cause. From puberty through menopause, menstrual bleeding typically happens at regular intervals. Nonetheless, issues can arise concerning either the nature or the timing of the bleeding.
Uterine bleeding that is not related to menstruation can be due to a range of factors. Hormonal medications like oral contraceptives might lead to light bleeding or spotting. Other potential causes include endometritis, an infection of the uterine lining, and endometrial cancer. Bleeding during the early stages of pregnancy could signify a risk of miscarriage. In later stages of pregnancy, bleeding might be an indicator of conditions such as placenta previa, where the placenta is implanted in the lower part of the uterus, or placental abruption, where the placenta partially or completely detaches from the uterine wall.
Bleeding that originates from the cervix could be the result of cervical erosion, and it may happen following sexual intercourse. Other potential causes include cervicitis, an infection of the cervix, and cervical polyps. In more severe cases, such bleeding could indicate the presence of cervical cancer.
One potential reason for vaginal bleeding is physical trauma during sexual activity, particularly after menopause when the vaginal walls become more delicate and thin. In some cases, severe vaginitis, or inflammation of the vagina, can also result in bleeding. Though uncommon, vaginal cancer can be another cause of such bleeding.