Vaginal bleeding - irregular

During each monthly cycle, the lining of the womb (uterus) gets thicker in readiness for pregnancy. A menstrual period occurs when a pregnancy has not taken place. The lining of the uterus is shed and the loss is 50 per cent blood, which can vary from bright red to dark brown. After each period, the whole cycle starts again.

Irregular vaginal bleeding is any bleeding from a woman’s vaginal area and usually refers to bleeding that is not part of a regular period. The range of causes includes infection and hormonal changes. If you suffer from ongoing bleeding problems, see your local doctor for a full assessment to make sure there is no underlying disorder causing the problem.

A wide range of ‘normal’ menstrual periods

Periods differ from woman to woman and from month to month. A period can last from three to 10 days, and occur every three to six weeks. This pattern can vary with age, stress, diet, exercise and inherited factors. The flow can also vary. Around 40ml (two tablespoons) of fluid is lost, which the body quickly replaces.

It is common for women to suffer some cramping pain with their period. This is felt just below the navel and may spread into the legs or lower back. It can be felt as a dull ache or sharp twinge. During a period it is also common to feel bloated and heavy, get more pimples, feel tense and emotional, and have sore breasts and greasier hair.

A range of causes

In many women, the cause of the irregular bleeding is not found. For others, the cause depends on their age and the site of bleeding. Once pregnancy has been ruled out, some of the known causes include:

• Hormonal changes
• Contraception such as the pill, injection or IUD (intrauterine device)
• Infection in the vagina or uterus
• Fibroids or polyps inside the uterus
• Trauma to the vagina
• Some medications such as anticoagulants or anti-epilepsy drugs
• Underlying health problems such as bleeding or thyroid disorders
• Cancer in the lining of the uterus, the cervix or vagina (rare).

Diagnosis methods

For some women, medical history and physical examination are enough for the doctor to be able to diagnose the cause of the irregular bleeding. For other women, a range of tests may be offered including:

• Cervical smear and swabs
• Pregnancy test
• Blood tests
• Ultrasound
• Dilation and curettage (D&C), which involves gently widening the cervix and scraping away the uterine lining.

Treatment options

Treatment depends on the cause but may include:

• Anti-inflammatory drugs
• Antibiotics
• Change of contraception
• Hormone therapy
• Anti-bleeding agents such as tranexamic acid
• Surgery to remove fibroids, polyps or cancers
• Treatment for any underlying health problem.

Taking care of yourself at home

If you have irregular bleeding, some general home care suggestions include:

• Get plenty of sleep
• Eat a well-balanced diet
• Do some gentle exercise
• Keep a diary of your symptoms to show your doctor.

Pain relief suggestions

If you suffer from pain with your bleeding, suggestions include:

• Rest. Curl your knees up to your chest and lie on your side.
• Place a warm pack, such as a hot water bottle or wheat bag, over your abdomen.
• Take a warm bath.
• Wear loose clothing.
• Exercise.
• Rub or massage where it hurts.
• Take painkillers such as paracetamol, but avoid aspirin.
• Try relaxation techniques.
• Consider increasing your intake of magnesium or vitamin B1.

More information

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women's Health.

Where to get help

• Your GP (doctor)
• Gynaecologist
• Sexual Health Victoria Tel. 1800 013 952