5 Conditions that Cause Vaginal Bleeding

Around 50% of women experience heavy menstruation during their reproductive years, and that’s just one type of abnormal vaginal bleeding. While bleeding is most often a healthy part of the natural menstrual cycle, it may sometimes signal an underlying condition that needs medical attention.

At Dunwoody OB/GYN, LLC, we want to keep our patients informed and ensure they feel comfortable seeking care when something doesn’t seem right. Here Alvin Sermons, MD, and Lisa Price, MD, discuss what constitutes problematic vaginal bleeding, what it might mean, and when to see your OB/GYN.

Abnormal uterine bleeding (AUB)

Normal menstrual bleeding occurs each month unless you become pregnant. It happens when the endometrium (uterine lining) detaches from the uterine walls. Menstruation usually takes place every 24-38 days, lasts 4-8 days, and involves a manageable flow.

AUB is vaginal bleeding that falls outside of this pattern. It’s a broad term that includes several issues:

• Heavy bleeding that quickly soaks through pads or tampons
• Irregular cycles (metrorrhagia)
• Spotting between periods
• Periods that come too close together or too far apart

You may also experience excessively painful menstruation (dysmenorrhea). Most AUB isn’t due to anything serious, but it’s important to rule out underlying conditions. Let’s take a closer look at five common problems that can cause vaginal bleeding and what you should know about them.

1. Hormonal imbalances

Your hormones have a critical role in regulating the menstrual cycle. When estrogen and progesterone levels shift too much, periods can become irregular, heavier, or longer than usual.

Hormonal imbalances can happen during puberty, perimenopause, or with conditions like polycystic ovary syndrome (PCOS). Stress, weight changes, and thyroid issues can also throw hormones off balance.

If you notice spotting between periods or cycles that are much heavier than before, we may recommend blood tests, lifestyle changes, or medications to restore balance.

2. Uterine fibroids

Fibroids are benign (noncancerous) tumors that often develop in or around the uterus. They’re very common and range in size from tiny nodules to grapefruit-sized growths. Many women with fibroids are unaware of them, but when symptoms do appear, heavy or prolonged menstrual bleeding is often one of them.

Some women also experience pelvic pressure, frequent urination, or difficulty becoming pregnant. Treatment depends on the size and location of the fibroids as well as your plans for future pregnancy. Options include medication, minimally invasive procedures, or surgery if symptoms are severe.

3. Endometrial polyps

Polyps are small, soft growths on the endometrium. They’re usually benign but can cause irregular bleeding, spotting between periods, or bleeding after sex.

Polyps are more common in women approaching menopause, but can occur at any age. We can often detect them with an ultrasound, or may need to do a hysteroscopy, where a tiny camera looks inside your uterus.

It’s possible to remove most polyps during a simple outpatient procedure, which often stops the abnormal bleeding.

4. Pregnancy-related causes

Bleeding during pregnancy can feel frightening, but it doesn’t always mean something is wrong. Light spotting may occur in early pregnancy due to implantation or changes in the cervix. However, heavier bleeding may signal complications such as:

• Miscarriage
• Ectopic pregnancy (embryo implantation outside the uterus)
• Placental problems later in pregnancy

Visit us for a prompt evaluation of any bleeding during pregnancy. Quick care can sometimes prevent complications, as well as provide peace of mind.

5. Gynecologic cancers

Though it’s less common than other causes, vaginal bleeding is sometimes a warning sign of cancer in the reproductive system.

Uterine, cervical, and vaginal cancers may all cause abnormal bleeding. You should always see us promptly for any postmenopausal bleeding (bleeding that happens after your periods have stopped for a year or more).

Early detection often makes treatment more effective. Regular Pap smears, human papillomavirus (HPV) testing, and routine gynecologic exams are essential tools for catching these conditions early.

When to see your OB/GYN about vaginal bleeding

While not all vaginal bleeding is a sign of a serious problem, it’s important to listen to your body and obtain medical advice if something feels unusual. You should schedule an appointment if you experience:

• Very heavy periods that soak through pads or tampons quickly
• Bleeding between periods or after sex
• Any bleeding after menopause
• Bleeding during pregnancy
• Severe pain along with bleeding

Don’t ignore changes in your cycle or unusual bleeding patterns — reaching out to your OB/GYN is always the safest choice. We can perform an exam, order tests such as ultrasounds or bloodwork, and recommend treatment based on the cause.

Whether you’re dealing with hormonal changes, fibroids, pregnancy-related issues, or something else, our team is here to support you. Call Dunwoody OB/GYN to discuss your vaginal bleeding concerns or use the online booking feature to schedule a consultation.