Abnormal Vaginal Bleeding as a Symptom of Gynecologic Cancer

Abnormal vaginal bleeding, also referred to as abnormal uterine bleeding, is experienced by about one-third of women at some point in their lives. Abnormalities can occur in the timing, volume, frequency, duration, and regularity of the bleeding.

Most of the time, a benign (non-cancerous) process causes bleeding or spotting, and hormonal fluctuations are often the culprit.

However, abnormal vaginal bleeding is also one of the most frequent symptoms experienced by women when they have gynecologic cancers such as cervical cancer, endometrial cancer, uterine cancer, or ovarian cancer.

This article reviews symptoms of abnormal vaginal bleeding, causes, diagnosis, and treatment. It also covers when abnormal vaginal bleeding can signal a serious problem.

Woman running to the toilet
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Symptoms

There are several instances in which vaginal bleeding would be considered abnormal:

  • Heavy bleeding during your period: A heavy period is menstrual bleeding that interferes with your quality of life. This includes sudden, heavy vaginal bleeding that soaks at least one pad every hour for 24 hours. This needs to be reported to a healthcare provider immediately. Bleeding that lasts more than 7 to 8 days is also considered heavy bleeding.
  • Bleeding or spotting between periods: Heavy spotting or an additional cycle in a month that occurs for more than two cycles should be evaluated by a healthcare provider.
  • Bleeding during or after sex or douching: Bleeding after sex and douching are both symptoms of cervical and vaginal cancer. This type of vaginal bleeding also needs to be reported to a healthcare provider.
  • Unusually short or long menstrual cycles: Menstrual cycles that last less than 24 days or more than 38 days.
  • Irregular periods: When the length of your menstrual cycle varies by more than eight to 10 days.
  • Bleeding after menopause: Any woman who is in menopause (has not had a period for 12 consecutive months) and experiences vaginal bleeding should see their healthcare provider.
  • Missed periods: Missing a period for three to six months.

Consult your healthcare provider if you have any vaginal bleeding that is not normal for you. 

Types of Abnormal Vaginal Bleeding

Abnormal vaginal or uterine bleeding is defined by the following types:

  • Acute: Sudden onset of heavy bleeding that requires immediate medical attention. This usually means that you are going through at least one pad or tampon per hour.
  • Chronic: Abnormal bleeding that happens frequently over a six-month timeframe. This may include abnormal acute vaginal bleeding episodes.

Causes

All gynecological cancers (except vulvar cancer) can cause abnormal vaginal bleeding. Other medical conditions that may cause it include:

What Medications Cause Abnormal Vaginal Bleeding?

Medications that can contribute to abnormal vaginal bleeding include:

Diagnosis

If you experience abnormal vaginal bleeding, your healthcare provider will ask you questions about when it occurs, how long it lasts, and how heavy the bleeding is.

Keeping a journal or notes can help you answer these questions. You can estimate the amount of bleeding by keeping track of how often you soak through a pad or tampon.

In addition, your healthcare provider may ask questions about any other symptoms. They may perform a pelvic exam, blood tests, colposcopy, ultrasound, hysteroscopy, or other diagnostic tests to help diagnose the cause of your abnormal vaginal bleeding.

Treatment

Depending on the underlying cause, treating abnormal vaginal bleeding can range from doing nothing to initiating hormonal birth control, using medications, or surgery. Aspirin and products containing aspirin can thin blood and increase bleeding and therefore should be avoided.

Summary

Abnormal vaginal bleeding or abnormal uterine bleeding is characterized by abnormalities in the timing, volume, frequency, duration, and regularity of the bleeding. Often, a benign (non-cancerous) process such as uterine fibroids, infection, or a certain medication causes bleeding. However, it can also be a symptom of gynecological cancers. 

Depending on the cause, your healthcare provider may just monitor it but some problems need to be treated with medications or surgery.

A Word From Verywell

Having abnormal vaginal bleeding can be scary, frustrating, and disruptive. Call your healthcare provider any time you have symptoms of abnormal vaginal uterine bleeding. This includes when it interferes with any aspect of your daily living or quality of life.

While it may feel uncomfortable to talk to your healthcare provider about bleeding or your period, they are used to these conversations and want to know so they can provide early diagnosis and treatment.

Frequently Asked Questions

  • At what ages is abnormal vaginal bleeding more common?

    Abnormal bleeding can happen at any age. It's very common when girls first start their period. Most girls start their periods between the ages of 12 and 13.

    Perimenopause (the time leading up to menopause) is also a common age to experience skipped, irregular, or changing menstrual cycles and bleeding. Perimenopause usually occurs in a woman's later 40s or early 50s. Both of these age estimates are averages, they can vary for each individual.

  • How long does abnormal vaginal bleeding last?

    Abnormal bleeding is considered chronic (or long-term) when it happens frequently for six months. When period bleeding lasts longer than 8 days, it is considered abnormal.

    Acute, sudden heavy bleeding occurs when you soak through a pad or tampon every hour for 24 hours. If this happens, notify a healthcare provider immediately.

  • Can stress cause abnormal vaginal bleeding?

    Yes, studies show that high levels of chronic stress can cause irregular menstrual periods.

Originally written by Lisa Fayed
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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Chodankar R, Critchley HOD. Abnormal uterine bleeding (including PALM COEIN classification). Obstet Gynaecol Reprod Med. 2019;29(4):98-104. doi:10.1016/j.ogrm.2019.01.009

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  4. U.S. Department of Health and Human Services: Office on Women's Health. Period problems.