Quick answer
What could vaginal bleeding mean?
Abnormal vaginal bleeding is bleeding between periods, after sex or after the menopause, or periods that are unusually heavy. Common causes include hormonal contraception, fibroids, polyps and infection, and most are treatable. Any bleeding after the menopause needs GP assessment, and heavy bleeding with dizziness or bleeding in pregnancy needs urgent care.
Understanding abnormal vaginal bleeding
Vaginal bleeding that falls outside your normal cycle — bleeding between periods, bleeding after sex, or periods that are much heavier than usual — should be reviewed by a GP. Many of the causes are common and treatable.
Bleeding after the menopause is always abnormal. It should always be checked, however light it is.
Common causes of abnormal vaginal bleeding
The most common causes are hormonal changes, fibroids, polyps and infection. Breakthrough bleeding is particularly common in the first months after starting hormonal contraception, and usually settles.
In anyone who bleeds after the menopause, doctors arrange tests to exclude endometrial cancer. The cause usually turns out to be something treatable, and it is rarely cancer.
How a GP assesses vaginal bleeding
A GP will ask about your bleeding pattern and medical history, and may examine you. Depending on what they find, they may arrange an ultrasound scan or refer you to a specialist.
They may also offer cervical screening if yours is due.
When vaginal bleeding is an emergency
Very heavy bleeding that makes you feel faint or dizzy needs urgent care. Any bleeding during pregnancy should be assessed the same day, and bleeding with pain in early pregnancy can be a sign of an ectopic pregnancy, which is a medical emergency — call 999 or go to A&E.
Common questions about vaginal bleeding
- Is it normal to bleed between periods?
- Bleeding between periods is common in the first few months after starting hormonal contraception. If the bleeding persists, or happens when nothing about your contraception has changed, it needs assessment by a GP.
- What does bleeding after the menopause mean?
- Bleeding after the menopause is always abnormal and should always be investigated by a GP. The cause is usually treatable and is rarely cancer, but tests are needed to rule this out.
- When are heavy periods an emergency?
- Seek urgent review if you are soaking through a pad or tampon every hour, or passing clots and feeling dizzy. Heavy periods are treatable, so see a GP even when the bleeding is not this severe.
- Why am I bleeding after sex?
- Bleeding after sex can be caused by a cervical ectropion, an infection or a polyp. It should always be checked by a GP so the cause can be identified and treated.