Vaginal Bleeding

Vaginal bleeding is when you pass blood from your vagina (birth canal).

The Vagina

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Sometimes yes and sometimes no. Vaginal bleeding is normal during your monthly period. Your period usually starts every 21 to 35 days (or up to 45 days in teenagers). Bleeding during a period usually lasts for 3 to 7 days. Girls usually get their first period when they are between 10 and 16 years old.

Newborn girls may have a little bit of vaginal bleeding for up to 2 weeks after being born—this is normal too. If the bleeding continues in newborns for more than 2 weeks, they should be seen by a doctor.

Bleeding is considered abnormal when you bleed:

• Before you get your very first period

• Between your periods

• While you're pregnant

• After you’ve stopped having periods (menopause)

Bleeding during your period may also be considered abnormal if your period:

• Lasts more than 7 days

• Is very heavy (you use more than 1 or 2 tampons or pads in an hour)

• Happens too frequently (starting fewer than 21 days apart)

• Happens too infrequently (starting more than 90 days apart)

It can be serious if you have a lot of bleeding. It can also be serious even if there's not much bleeding but the cause is serious (for example, cancer).

If you have bleeding that goes on for a long time, your blood count will be low (anemia). Anemia makes you look pale and feel tired all the time. Your body will also be low on iron, because red blood cells have iron in them. If you have a lot of bleeding all at once, your blood pressure may become dangerously low (a condition called shock) and you may pass out.

Common causes of abnormal bleeding depend on how old you are.

Little girls may be hurt or have something stuck in their vagina, like toilet paper or a toy. Girls younger than 8 years old may be starting puberty too early. Sexual abuse can also be a cause of vaginal bleeding.

Girls just starting to have periods or women just ending their periods may have abnormal bleeding because of changes in their hormones. Some girls or women may have an inherited problem with blood clotting.

Young and middle-aged women may have:

• Pregnancy problems (miscarriage, pregnancy in the wrong place [ectopic pregnancy])

• Fibroids (tumors in the uterus that can be painful but don’t cause cancer)

• Spotting due to birth control pills

In older women who no longer get periods, bleeding can be caused by hormone problems or cancer.

See a doctor right away if you have vaginal bleeding and any of these warning signs:

• Fainting, weakness, dizziness, cold and sweaty skin, trouble breathing, or a heart beat that is weak or very fast

• Bleeding during pregnancy

• Bleeding too much during your period—using more than 1 pad or tampon in an hour for a few hours

• Passing large blood clots or clumps of tissue

You should also see a doctor right away if you have signs of a bleeding disorder:

• You bruise easily

• You bleed a lot when you brush your teeth or get a small cut

• You have tiny reddish-purple dots or larger splotches on your skin

See a doctor within a week if you don’t have any warning signs but have abnormal bleeding, including if you have vaginal bleeding before your menstrual periods start (before puberty) or after they stop (after menopause).

A newborn girl who bleeds for more than 2 weeks should be seen by a doctor.

Doctors will ask questions about your vaginal bleeding, other symptoms, and your usual monthly period.

Doctors typically do a pelvic exam. During a pelvic exam, your doctor looks inside your vagina and cervix (the lower part of your uterus). In order to see inside, your doctor will hold your vagina open with a small instrument called a speculum.

They may do a urine pregnancy test, blood tests, and maybe an ultrasound (using sound waves to create moving pictures of the insides of your pelvic area).

Doctors will treat the cause of your bleeding. For example, if you have a tumor or other growth, doctors may do surgery to remove it.

If the bleeding has caused you to have too little iron in your blood, you may need to take iron pills.

If you’ve lost too much blood all at once and are in shock, doctors will give you IV fluids or blood transfusions (fluid or blood that goes directly into your vein). This will help raise your blood pressure.