Vaginal bleeding - Causes and Symptoms

Definition

Vaginal bleeding is a condition characterized by loss of blood from the uterus, the cervix (cervix) or the vaginal canal itself. This symptom can occur in pregnancy or outside of it.

Abnormal vaginal bleeding includes:

Excessive menstruation due to quantity and duration (menorrhagia or hypermenorrhea) or too frequent (polymenorrhea);
Uterine hemorrhage outside the menstrual period, at irregular intervals (metrorrhagia);
Post-menopausal blood loss, after 6 or more months after the last menstruation.

Several other pathologies can manifest themselves with this symptom: dysfunctional hormonal changes (imbalances in the hypothalamic-pituitary-gonadal axis with anovulatory cycle), neoplasms (cervical cancer, endometrial carcinoma and uterine fibromyoma), infections and inflammations of the genital apparatus (chlamydia, gonorrhea, vaginitis, endometritis, cervicitis and pelvic inflammatory disease).

Vaginal bleeding may also depend on ovulatory disorders (eg polycystic ovary syndrome and functional ovarian cysts) blood dyscrasias (hemophilias, leukemia and thrombocytopenias of various kinds) and systemic diseases (chronic liver diseases, renal insufficiency, hyperprolactinemia and thyroid dysfunction). ).

In adult women, abnormal vaginal bleeding may result from endometriosis, trauma (eg introduction of foreign bodies into the vagina or lesions of the cervix, vagina or vulva), use of the endouterine spiral and certain drugs (anticoagulants and oral contraceptives).

Vaginal bleeding after menopause

Post-menopausal blood loss can be caused by atrophic vaginitis, polyps, hyperplasia and endometrial atrophy.

In some cases, bleeding is a consequence of the withdrawal of exogenous hormones (hormone replacement therapy).

When they occur, vaginal bleeding would still be considered an abnormal signal that always requires adequate assessment to rule out the presence of a malignant gynecological tumor. In fact, carcinoma of the uterine cervix and endometrium can cause metrorrhages in menopause, sometimes with leucorrhoea, soft or hypoplastic uterus and pain in the iliac fossa.

Vaginal bleeding during pregnancy

Vaginal bleeding may occur in the early or late stages of pregnancy. The blood loss caused by the embryo implantation is rather frequent.

Vaginal bleeding can result from spontaneous abortions, extrauterine pregnancies and untimely detachment of the placenta. Other pregnancy-related complications that may occur with this symptom include gestational trophoblastic disease, placental polyps and placenta previa.