Abnormal Vaginal Bleeding

Abnormal vaginal bleeding is also called Breakthrough Bleeding (BTB). Breakthrough Bleeding is one of the various forms of vaginal bleeding. It is classified as a form of Metrorrhagia. Bleeding is usually light and is referred as Spotting. However, some women can suffer heavy bleeding. Breakthrough bleeding in many women tends to cease after one or two cycles.


Causes for Breakthrough Bleeding are as follows.

  • The most common cause for Breakthrough Bleeding is thick Endometrium (Uterine Lining).

  • Hormonal Effects of Ovulation can cause Breakthrough Bleeding.

  • It can be an early symptom of pregnancy.

  • It most commonly happens when women start or change their Oral Contraceptives pills (birth control pills).

  • Smokers, while using Contraceptives, are more prone to it.

  • It can also happen due to Hormonal Fluctuations. Body produces several Hormones like Follicle Stimulating Hormone (FSH), luteinizing hormones (LH), estrogen and  Progesterone. These hormones regulate the shedding of Endometrial. Contraceptives are nothing but synthetic derivatives of estrogen. When a females eat contraceptive pills, she is actually increasing the amount of estrogen in her body. This further speeds up the shedding of endometrium, combined with bleeding.


To evaluate Abnormal Vaginal Bleeding following diagnostic tests are used.

  • Pelvic Examination is physical examination for the detection of Cervical Polyps or unusual masses in Uterus or Ovaries that might be causing abnormal bleeding.

  • Pap Smear Test is taken to rule out Cervical Cancer. This test also helps in the identification of infections like Gonorrhea.

  • Pregnancy Test for Premenopausal women.

  • Blood Count to rule out Anemia (low blood count) due to excessive bleeding.

  • Blood Test samples of blood are taken for evaluating abnormalities of Liver, Thyroid or Kidney.

  • Pelvic Ultrasound is done for pelvic examination.


Treatments for Abnormal Vaginal Bleeding are as follows.

  • If the cause is lack of Ovulation then Progesterone or Oral Contraceptives having Progesterone should be taken at regular intervals.

  • If the cause is Precancerous Changes then Progesterone medications are used.

  • If the cause is Benign Growth then surgical removal is preferred.

  • If nothing works, a surgical procedure called Hysterectomy is performed.