Help, There's Blood!!

Main source: Dr Nor Ashkin Mokhtar (consultant obstetrician and gynaecologist). Star Newspaper (8 July 2007)


For a woman, bleeding is an ordinary occurence every month. However there are times when vaginal bleeding can be abnormal n cause for concern.

The presence of unexpected blood, whether or in large or small amounts...can be frightening for them. But the good news is wud be it's not necessarily due to a serious condition. But then again its better to have any abnormal vaginal bleeding checked out by the doctor.

Basically irregular vaginal bleeding can be a little or even a lot. It can range from spotting of small amounts of blood between the menstrual periods to heavy periods that wud soak up pad after pad. Yet most women experience some irregular bleeding at some point. Sometimes bleeding a couple of days passing the usual lengths of their menstrual periods or they spot a bit of blood during the periods. So my question is....When is irregular bleeding really abnormal?? Here are some clues:

• Bleeding at the time when they are not expecting their menstrual period
• Having a menstrual flow that is lighter or heavier than what is normal for them
• Bleeding at an unexpected time in life such as age before 10yrs for young girls, when woman are pregnant or even after menopause

The common conditions of irregular vaginal bleeding between periods can be:

• the experience of extreme physical or emotional stress by women at sometime of their life
• the usage of contraceptives such a intrauterine device (IUD) or hormonal birth control pills or implants.
• Refusal of breastfeeding
• woman being menopausal and on hormone therapy

The conditions above can be a common cause as to why bleeding occurs between periods n if the bleeding isn't to heavy, then its kind of normal n woman shouldn't get to alarmed yet as necessary precautions can be taken to prevent this. BUT if the the bleeding is too frequent n to heavilly, then the common conditions that I mentioned above may not support to this. It may indicate to other more serious conditions. The abnormal vaginal bleeding can be due to the non-cancerous conditions like such as infections of the vagina, cervix, uterus fallopion tubes or ovaries. These infections are most commonly introduced by sexually transmitted diseases (STD).

It can be also due to cancerous conditions such as possibility of tumuors, polypeptides or formations of fibroids. These growths can occur in the vaginal parts, cervix, uterus or fallopion tubes. The bleeding can also be from the hormonal imbalances in the body.

In cases related to pregnant woman, they should be aware that abnormal vaginal bleeding can indicate a problem with the unborn baby. A sudden heavy period may disguise what is actually a miscarriage during an early pregnancy. If heavy bleeding is sustained after 12th week of pregnancy, it may be due to an infection such as ectopic pregnancy (where the foetus is planted outside the uterus) or a miscarriage.

But if women experience heavy bleeding in the 1st few weeks after giving birth or after a therapeutic abortion, it may be due to the products of conception are still in the uterus or the uterus hasn't contracted to its pre-pregnancy size.

Abnormal vaginal bleeding among young girls aging below 10, could be the sign of sexual abuse.

Blood turning up at unexpected times can be scary but dont get panic. Do make a record of when n how much n how often irregular bleeding occurs b4 seeing the family physician or the gynaecologist. Be open minded n tell everything of what u have or u know to them. Even when u suspect of having pregnancy or u are, then go to the doctor immediately if u have vaginal bleeding.

If the doctor has ruled out all the normal causes of common conditions (as i mentioned above) of vaginal bleeding then he/she would conduct few test to see what is wrong. Such test like pelvic exam, Pap smear (a medical screening method, primarily designed to detect premalignant and malignant processes in the ectocervix. It may also detect infections and abnormalities in the endocervix and endometrium. Done by obtaining samples from the outer opening or os of the cervix using an Aylesbury spatula and an endocervical brush), and laboratory test and ultra sound or pregnancy test, endometrial biopsy n hysteroscopy. Hysteroscopy is the inspection of the uterine cavity by endoscopy. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy).

This inspection is done by an endoscopic device known as hysteroscope. The hysteroscope has an optical system usually now connected to a video system, a light bearing system with fiberoptics, and a channel for delivery of a distention medium. The uterine cavity is a potential cavity, for inspection it needs to be distended. Thus during hysteroscopy either fluid (saline, sorbitol, or a dextrane solution) or CO2 gas is introduced to expand the cavity. After cervical dilation, the hysteroscope is guided into the uterine cavity and an inspection is performed. If abnormalities are found, an operative hysteroscope also has a channel to allow specialized instruments to enter the cavity and perform surgery. Typically hysteroscopic intervention is done under anesthesia, but a diagnostic procedure can be performed without anesthesia with instruments of smaller caliber.

The treatment for vaginal bleeding is depending to the conditions for the bleeding to occur. If the bleeding is related to a medical condition (infection for instance) or a physical condition (such as an IUD) then it can be relieved by treating the underlying condition. If the abnormal bleeding isn't related to underlying diseases or conditions, then it may be treatable with hormone pills.

At the same time, anemia also shud be monitored as well since the loss of blood during bleeding can lead to massive iron loss in the body.The doctor wud prescribe iron supplements incase this happens.

Its better to see a doctor immediately incase something out of ordinary happens.