Abnormal vaginal bleeding

Bleeding that is not a normal period could be caused by:

• hormonal changes (such as starting menopause or polycystic ovary syndrome)
• contraception such as the pill, injection, implant or IUD (intrauterine device)
• infection in your vagina or uterus
• fibroids or polyps inside your uterus
• trauma to your vagina
• some medications such as anticoagulants
• underlying health problems such as bleeding or thyroid disorders
• cancer in the lining of your uterus, your cervix or vagina (this is rare).

There is a wide range in what is 'normal' for periods. They can last from 3 to 10 days, and happen every 3 to 6 weeks. Variations can be caused by age, stress, diet, exercise and other medical conditions.

See your healthcare provider if:

• you are worried about abnormal bleeding
• your periods have changed, especially if you have more frequent or heavier bleeding
• you have bleeding after sex
• you have been through menopause (no longer have periods) and have any bleeding.

If you are not sure what to do call Healthline 0800 611 116

Your healthcare provider will examine you and check your medical history. You may need some tests, including:

• cervical screening
• pregnancy test
• blood tests
• ultrasound
• endometrial sampling (a small tube like a straw is passed through the cervix and the lining of the uterus is gently collected by suction)
• dilation and curettage (gently widening the cervix and scraping away the lining of the uterus)
• hysteroscopy (the lining of the uterus is viewed with an instrument).

A dilation and curettage, and hysteroscopy will be done under anaesthetic. The 2 tests may be done together.

Treatment for the bleeding depends on what has caused it, but may include:

• anti-inflammatory drugs
• antibiotics
• change of contraception
• hormone therapy, including slow release implants
• medicines to block the breakdown of blood clots to prevent bleeding, such as tranexamic acid
• surgery to remove fibroids, polyps or cancer
• treatment for any underlying health problem.

If you have abnormal bleeding make sure you:

• get plenty of sleep
• eat a well-balanced diet
• do some gentle exercise
• keep a diary of your symptoms to show your healthcare provider.

If you have pain with your bleeding:

• rest — curl your knees up to your chest and lie on your side
• place something warm on your tummy, like a hot water bottle or wheat bag
• rub or massage where it hurts
• take painkillers such as paracetamol or ibuprofen — avoid aspirin
• try relaxation techniques.