What is Abnormal Bleeding?

Abnormal vaginal bleeding is not something that women should have to live with and can be related to a number of reproductive or medical conditions. Normal menstrual bleeding usually occurs every 21-35 days and lasts for around seven days (this can vary). While it is normal for there to be some variation between each cycle, you should not experience frequent vaginal bleeding between periods.

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There are many different causes of intermenstrual bleeding or vaginal bleeding that occurs during the menstrual cycle other than during regular menstruation, including:

  • Polyps: An overgrowth of cells around a small blood vessel is called a polyp, which can occur on the cervix or inside of the uterus.
  • Contraceptives: Certain methods of contraception can cause abnormal bleeding, specifically in the first few months after starting the new method.
  • Pelvic infections: Bleeding between periods may be a sign of an infection on the cervix or in the uterus. Patients who have a pelvic infection can experience pelvic pain or increased vaginal discharge along with bleeding.
  • C-section scar defects: Some women who have undergone a cesarean section may experience bleeding that begins just after the end of their regular menstruation.
  • Cancer or precancer: Cancer or a precancerous growth located on the uterus or cervix can be the cause of intermenstrual bleeding.

Some women may also experience what is known as irregular bleeding, which is when a woman experiences phases of no bleeding that may last for two or more months and other phases with spotty or heavy bleeding. Irregular bleeding is usually related to abnormal ovulation or polycystic ovarian syndrome (PCOS).


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How is Abnormal Bleeding Diagnosed?

In order to diagnose abnormal bleeding, Dr. Tepper will speak with you regarding your health history and the characteristics of your menstrual cycle. You may also be asked to keep track of your menstrual cycle, noting dates, length, and amount of bleeding. He will perform a physical exam, and may also recommend blood tests to check your hormone levels and blood count. You may also have a pregnancy test or tests for sexually transmitted infections (STIs).

Based on your symptoms, age, and Dr. Tepper’s findings, he may have you undergo some additional testing. These may include an ultrasound, MRI, CT, endometrial biopsy, and more to determine the exact cause of your abnormal bleeding.

Treatment Options for Abnormal Bleeding

The treatment that is right for you will depend on the cause of your abnormal bleeding, which Dr. Tepper will discuss with you during your appointment. Some treatment options that may help to resolve your abnormal bleeding include:

  • Hormonal birth control: Birth control pills, patches, or vaginal rings that contain hormones can help to lighten menstrual flows and regulate periods.
  • Intrauterine device (IUD): An IUD is a small, plastic device that is inserted into the uterus to prevent pregnancy. The type of IUD that releases hormones can be used to reduce abnormal bleeding in some women.
  • A D&C (dilation and curettage): A D&C is a procedure done to scrape away the lining of the uterus. The removed lining is then examined in a lab for abnormal tissue. Women experiencing heavy bleeding may undergo this procedure to determine the cause for, and treat, the bleeding.
  • Endometrial ablation: This procedure destroys the lining of the uterus. This treatment may stop all menstrual bleeding in some women.
  • Hysterectomy: This is a surgical procedure to remove the uterus. Women who have a hysterectomy will not have any more periods and will not be able to get pregnant.

Can stress cause longer periods?

Yes, stress can lead to longer menstrual cycles. Progesterone, a hormone necessary for cortisol production (the stress hormone), is part of what controls your menstrual cycle. With more cortisol, there is more progesterone and that can lead to longer periods.

Can stress cause postmenopausal bleeding?

High levels of stress can lead to bleeding postmenopause. Because your hormone levels can be out of balance during moments of high stress, it can lead to spotting or post-menopausal bleeding.

Is excessive bleeding a sign of cancer?

Yes. Irregular or excessive bleeding, especially from the vagina, can be a sign of uterine, ovarian, or cervical cancer. If you have any excessive bleeding, call your doctor immediately.

What causes prolonged bleeding?

Prolonged bleeding can have several causes, including fibroids, anemia, polyps, hormone changes, uterine problems, and cancer.

What is abnormal vaginal bleeding?

Abnormal vaginal bleeding is bleeding that occurs that is different from your normal period. It may be simple spotting, or it may be heavier.

What is excessive bleeding a sign of?

Excessive bleeding can be a sign of several conditions, including uterine, cervical, or ovarian cancer, fibroids, polyps, hormone imbalance, and adenomyosis.

What is the first sign of uterine cancer?

The first sign of uterine cancer is abnormal vaginal bleeding. This can occur between periods before menopause or at any time after menopause.

What is the most common cause of dysfunctional uterine bleeding?

The most common cause of dysfunctional uterine bleeding is an imbalance in sex hormones.

What medicine can stop bleeding?

Tranexamic acid is a medication used to help the blood clot properly and can stop bleeding during a heavy period.

What would cause an elderly woman to bleed?

Bleeding in an elderly woman can be caused by a number of factors, and the cause can depend on where the bleeding is coming from. For vaginal bleeding, the cause can include cancer, polyps, and severe vaginal dryness.

When should you go to the hospital for bleeding?

If you are losing a significant amount of blood and the blood does not seem to be stopping, you should go to the hospital or call 911 immediately.

Why am I bleeding while on the pill?

The reason for bleeding while on oral contraceptives isn't always completely clear, but it can be due to the body needing time to adjust to the hormones in the pill. It can also take time for the uterus to adjust to transitioning to a thinner lining. You may also experience bleeding if you miss a pill.


Whether you are a new or returning patient, Dr. Tepper can assess your concerns and discuss your options to find the most comfortable and convenient care for you. To get started, call our office to set up an appointment.


Contact Us to Learn More

Are you experiencing abnormal bleeding and are in need of a professional opinion? If so, contact our office today at (212) 828-0900 to schedule an appointment with Dr. Tepper.

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