Causes of abnormal vaginal bleeding

Causes of abnormal bleeding

Abnormal vaginal bleeding has many possible causes. By itself, it does not necessarily indicate a serious condition.
Many women experience abnormal vaginal bleeding or spotting between periods sometime in their lives. Vaginal bleeding is considered to be abnormal if it occurs:

• When you are not expecting your menstrual period.
• When your menstrual flow is lighter or heavier than what is normal for you.
• At a time in life when it is not expected, such as before age 10, when you are pregnant, or after menopause.

Causes of abnormal bleeding

Abnormal vaginal bleeding has many possible causes. By itself, it does not necessarily indicate a serious condition.

• Because bleeding can indicate a problem with pregnancy, possible pregnancy should always be considered in a woman of childbearing age.
  • Spotting to minimal bleeding may be normal, but any bleeding during pregnancy needs to be evaluated by your doctor.
  • Heavy vaginal bleeding or bleeding that occurs before 12 weeks may indicate a serious problem, including an ectopic pregnancy or miscarriage.
  • Heavy vaginal bleeding or bleeding that occurs after 12 weeks also may indicate a serious problem, such as placenta previa.
• Ovulation can cause midcycle bleeding.
• Polycystic ovary syndrome (PCOS) is a hormone imbalance that interferes with normal ovulation which can cause abnormal bleeding.
• Medicines, such as birth control pills, sometimes cause abnormal vaginal bleeding. You may have minor bleeding between periods during the first few months if you have recently started using birth control pills. You also may have bleeding if you do not take your pills at a regular time each day. For more information, see the topic Birth Control.
• An intrauterine device (IUD) also may increase your chances of spotting or heavy periods. For more information on the IUD, see the topic Birth Control.
• Infection of the pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause vaginal bleeding, especially after intercourse or douching. Sexually transmitted diseases (STDs) are often the cause of infections. For more information, see the topic Exposure to Sexually Transmitted Diseases.
• Pelvic inflammatory disease (PID) causes inflammation or infection of the uterus, fallopian tubes, or ovaries which can cause abnormal bleeding.

Other, less common causes of abnormal vaginal bleeding that may be more serious include:

• Sexual abuse.
• An object in the vagina.
• Uterine fibroids, which are a common cause of heavy periods. For more information, see the topic Uterine Fibroids.
• Structural problems, such as urethral prolapse or polyps.
• Cancer of the cervix, uterus, ovaries, or vagina.
• Extreme emotional stress and excessive exercise. But excessive exercise more frequently causes an absence of menstruation (amenorrhea).
• Other diseases, such as hyperthyroidism or diabetes.

Heavy bleeding during the first few weeks after delivery (postpartum) or after an abortion may occur because the uterus has not contracted to the prepregnancy size or because fetal tissue remains in the uterus (retained products of conception).
If you are age 40 or older, abnormal vaginal bleeding may mean that you are entering perimenopause. In a woman who has not had a menstrual period for 12 months, vaginal bleeding is always abnormal and should be discussed with your doctor.
Treatment of abnormal vaginal bleeding depends on the cause of the bleeding.
Use the Check Your Symptoms section to decide if and when you should see a doctor.

Colon Cancer Symptoms

Colon Cancer Symptoms

Cancer of the colon and rectum can exhibit itself in several ways. If you have any of these symptoms, seek immediate medical help.
You may notice bleeding from your rectum orblood mixed with your stool.

• People commonly attribute all rectal bleeding to hemorrhoids, thus preventing early diagnosis owing to lack of concern over "bleeding hemorrhoids."
  
• Rectal bleeding may be hidden and chronic and may show up as an iron deficiency anemia.
  
• It may be associated with fatigue and pale skin.
  
• It usually, but not always, can be detected through a fecal occult (hidden) blood test, in which samples of stool are submitted to a lab for detection of blood.

If the tumor gets large enough, it may completely or partially block your colon. You may notice the following symptoms of bowel obstruction:

• Abdominal distension: Your belly sticks out more than it did before without weight gain.
  
• Abdominal pain: This is rare in colon cancer. One cause is tearing (perforation) of the bowel. Leaking of bowel contents into the pelvis can cause inflammation (peritonitis) and infection.
  
• Unexplained, persistent nausea or vomiting
  
• Unexplained weight loss
  
• Change in frequency or character of stool (bowel movements)
  
• Small-caliber (narrow) or ribbon-like stools
  
• Sensation of incomplete evacuation after a bowel movement
  
• Rectal pain: Pain rarely occurs with colon cancer and usually indicates a bulky tumor in the rectum that may invade surrounding tissue.

Studies suggest that the average duration of symptoms (from onset to diagnosis) is 14 weeks. There is no association between overall duration of symptoms and the stage of your tumor.

ISSUES RELATING TO BREAST CANCER

If you have received a positive or possible diagnosis of breast cancer, there are a number of questions that you can ask your doctor. The answers you receive to these questions should give you a better understanding of your specific diagnosis and the corresponding treatment. It is usually helpful to write your questions down before you meet with your health-care provider. This gives you the opportunity to ask all your questions in an organized fashion.

Each question is followed by a brief explanation as to why that particular question is important. We will not attempt to answer these questions in detail here because each individual case is just that, individual. This outline is designed to provide a framework to help you and your family make certain that most of the important questions in breast cancer diagnosis and treatment have been addressed. As cancer treatments are constantly evolving, specific recommendations and treatments might change and you should always confer with your treatment team regarding any questions. You obviously should add your own questions and concerns to these when you have a discussion with your doctor.

Is the doctor sure I have breast cancer?

Certain types of cancer are relatively easy to identify by standard microscopic evaluation of the tissue. This is generally true for the most common types of breast cancer. This obviously implies that you have had a biopsy that was then reviewed by a pathologist.

However, as the search for earlier and rarer forms of breast cancer progresses, it can be difficult to be certain that a particular group of cells is malignant (cancerous). At the same time, benign conditions may have cells which are somewhat distorted in appearance or pattern of growth (known as atypical cells or atypical hyperplasia). For this reason, it is important that the pathologist reading the slides of your breast biopsy be experienced in breast pathology. Most good pathology groups have multiple pathologists review questionable or troublesome slides. In more difficult cases, the slides will often be sent to recognized specialists with considerable expertise in breast pathology.