Hypomenorrhea Vaginal Bleeding Menstruation

What is Normal Vaginal Bleeding ?

This is the periodic blood in women's that flows as a discharge from the women's uterus. Vaginal bleeding menstruation is called menorrhea. Menstruation is the name by which menorrhea process occurs.

As a cyclic hormonal changes make a result, Vaginal bleeding Menstruation. In the ovaries have the most important hormonoes which control the development of female body, for example breast, body shape and body hair.

The mestrual cycle is regulated by the hormones. The female gonad is a pair of reproductive glands in woman. In the pelvis the female gonad is located near the uterus. The size and the shape of each ovary is the same. All the ovaries produce eggs and hormones. Each menstrud cycle and it is released fromone ovary. The ova or egg travels from the ovary through a Fallopian tube to the uterus.

The cycle ends with the shedding of part of the inner lining of UTERUS. DAY 1 is designated as first day of the menstrud. Menses are the time of the cycle. The menses occurs 4 weeks intervals, it s the menstrual cycle. The time in a girl's life has first begins, It is called menarlhe. When the function of the ovaries ceases is menopause. The age of menopause is from 51 years old.

What is abnormal vaginal bleeding ?

The flow of blood comes to the vagina , may be happen at the wrong time during the month., Whether bleeding is abnormal and its cause the medicine makes some questions. Are the women pregnant ? are they ovulating ?

All the women who think they have an irregular menstrual bleeding pattern must think carefully about theirs particular situation. Additionally the doctor will require some details of theirs menstrual history. All menstrual disturbance have a particular list of causes , testing and treatment.

1. Has the woman got abnormal vaginal bleeding pregnancy ?
During pregnancy much of the abnormal vaginal bleeding. Irregular bleeding may be a sign of early pregnancy even a woman is aware of he condition.

The pattern of the abnormal bleeding are duration and the interval. Long duration of menstrual bleeding is called HPERMENORRHEA and too short period is called HYPOMENORRHEA.

A woman's menstrual periods can occur too frequently POLYMENORRHEA. When the duration can excessively is called METRORRHAGIA. All the women can either have little volume is called hypomenorrhea.

2. Is the woman ovulating?
The ovary does an egg usually per month. It is ovulation. A normal woman has regular periods. Some clues have a woman ovulation.

They are : VAGINAL MUCUS, FLUID ETENTION,MENSTRUAL CRAMPS, BACK PAIN, MOOD CHARGES.

The doctor must order hormone blood TEST -progesterone level-Control daily home body temperature and Endometrial sampling. With all this can be determine If she is ovulating normally.

May be that a woman is not ovulating regularly or not have menstrual period. The doctors determine with endometrial sampling.

With heavy menstrual bleeding happen in about 10% of women. It can cause EMOTIONAL DISTRESS severe crashing.

The blood loss can cause ANEMIA. That requires urgent treatment.

Noncancerous causes of menorrhagia includes :

• Uterine fibroids they are benign tumors of smooth muscle tissue).
• Endometrial Polyps (tiny benign growths that protrude into the womb).
• Adenomyosis.
• Intrauterine devices (IUD's).
• Hypothyroidism, is the underactive thyroid function.
• Autoimmune disorder (systemic lupus erythematosus).
• Blood clotting disorders.

Menorrhagia can be a sign of endometrial cancer.It's more frequent in female over the 40 age. There are a lot of causes of menorrhagia in a female. It must found the specific cause after a medical evaluation. They are said to have dysfunctional uterine. It is found in female with dysfunctional uterine. With the new medicine we can found treatments to reduce the severity of the condition.


It's well known what cause menorrhagia in a female. All the female with uterine fibroids may be experiencing menorrhagia by endometrial hyperplasia. The heavy bleeding does not require evaluation with a doctor. A female with menorrhagia must visit a doctor. A female over 40 and under age often referred to a gynecologist for feether evaluation. A female may be referred to a gynecologist If she persistently bleeds.

Polymenorrhea
This is the irregular Vaginal Bleeding Menstrual periods. Polymenorrhea can be caused by sexually transmitted diseases chamydia STDS, eg.: gonorrhea or chamydia. It causes inflammation in the uters or pelvic inflammatory disease. Endometrioris is a condition of unknown cause that can lead pelvic pain. Maybe the cause of polymenorrhea is unclear in which case she has dysfunctional uterine.

Menstrual periods at irregular intervals (metrorrhagia)
Irregular menstrual periods (metrorrhagia) can be due to benign growths in the cervix, such as cervical polyps. The cause of these growths is usually not known. Metrorrhagia can also be caused by infections of the uterus (endometritis) and use of birth control pills (oral contraceptives). Sometimes after an evaluation, a woman's doctor might determine that her metrorrhagia does not have an identifiable cause and that further evaluation is not necessary at that time.

Decreased amount or duration of menstrual flow (hypomenorrhea)
An overactive thyroid function (hyperthyroidism) or certain kidney diseases can both cause hypomenorrhea. Oral contraceptive pills can also cause hypomenorrhea. It is important for women to know that lighter, shorter, or even absent menstrual periods as a result of taking oral contraceptive pills does not indicate that the contraceptive effect of the oral contraceptive pills is inadequate. In fact, many women enjoy this "side effect" of oral contraceptives.

Bleeding between menstrual periods (intermenstrual bleeding)
Women who are ovulating normally can experience light bleeding (sometimes referred to as “spotting”) between menstrual periods. Hormonal birth control methods (oral contraceptive pills or patches) as well as IUD use for contraception may sometimes lead to light bleeding between periods. Psychological stress, certain medications such as anticoagulant drugs, and fluctuations in hormone levels may all be causes of light bleeding between periods. Other conditions that cause abnormal menstrual bleeding, or bleeding in women who are not ovulating regularly (see below) can also be the cause of intermenstrual bleeding.

What conditions cause abnormal vaginal bleeding in women who are NOT ovulating regularly or vaginal bleeding after menopause?
Many conditions can interfere with the proper function of female hormones that are necessary for ovulation. For example, many conditions or circumstances may cause oligomenorrhea (reduction in the number of menstrual periods and/or amount of flow than usual) such as:

• If a woman has chronic medical illnesses or is under significant medical or emotional stress, can begin to have a loss of her menstrual periods.
• Malfunction of a particular part of the brain, called the hypothalamus, can cause oligomenorrhea.
• Anorexia nervosa is an eating disorder associated with excessive thinness that causes many serious medical consequences as well as oligomenorrhea.
• Polycystic ovarian syndrome (PCO) is a hormonal problem that causes women to have a variety of symptoms that include irregular or no menstrual periods, acne, obesity, infertility, and excessive hair growth; that are detectable with blood tests. For more, please read the Polycystic Ovarian Syndrome article.

The complete loss of ovulation is referred to as anovulation. Since ovulation allows the body to maintain an adequate supply of progesterone, anovulation is a condition in which a woman's hormonal balance is tipped toward too much estrogen and not enough progesterone. The excess estrogen is like a vitamin for the lining of the uterus. The result is that the lining of the uterus becomes too thick, which eventually leads to an increased risk of uterine pre-cancer or uterine cancer over many years. In order to replace progesterone and establish a proper hormonal balance, doctors will prescribe either progesterone to be taken at regular intervals, or an oral contraceptive that contains progesterone. Such treatment dramatically decreases the risk of uterine cancer in women who do not ovulate. Because uterine cancer results from many years of anovulation, any woman with prolonged anovulation needs to be treated to avoid developing uterine cancer.

Women who are postmenopausal should not experience vaginal bleeding. Any vaginal bleeding is considered abnormal in postmenopausal women. Women who are taking combined estrogen and progesterone hormone therapy (HRT) may experience some light, irregular vaginal bleeding during the first six months of treatment. Likewise, postmenopausal women who are taking a cyclic hormone regimen (oral estrogen and a progestin for 10-12 days per month) may experience some vaginal bleeding that is similar to a menstrual period for a few days each month.

Postmenopausal women who experience heavy or prolonged vaginal bleeding while on HRT should always see a doctor to rule-out more serious causes of vaginal bleeding. Less frequent but serious causes of vaginal bleeding in postmenopausal women include endometrial cancer or hyperplasia (overgrowth of the lining tissues of the uterus, which can be precancerous in some cases).

What causes vaginal bleeding during or after sexual intercourse?
Vaginal bleeding may occur during or after sexual intercourse for a number of reasons including:

• Injuries to the vaginal wall or introitus (opening to the vagina) during intercourse
• Infections (e.g. gonorrhea, chlamydia, yeast infections) are a cause of vaginal bleeding after intercourse.
• Lowered estrogen levels in peri-menopausal or postmenopausal women may cause the lining of the vagina to become thinned and easily inflamed or infected, and these changes can be associated with vaginal bleeding after intercourse.
• Anatomical lesions, such as tumors or polyps on the cervix or vaginal wall may lead to vaginal bleeding during or after intercourse.

Women who experience vaginal bleeding during or following sexual intercourse should always visit their doctor to determine the cause of the bleeding.

What causes abnormal vaginal bleeding during pregnancy?
Many women have some amount of vaginal bleeding during pregnancy. Some studies show that up to 30% of pregnant women will experience some degree of vaginal bleeding while they are pregnant. Vaginal bleeding during pregnancy is more common with twins and other multiple gestations than with singleton pregnancies (pregnancy with one fetus). Sometimes woman experience a very scant amount of bleeding in the first two weeks of pregnancy, usually around the time of the expected menstrual period. This slight bleeding is sometimes referred to as "implantation bleeding." Doctors do not know for certain what causes this bleeding, but it may occur as a result of the fertilized egg implanting in the uterine wall.

The amount of the bleeding, the stage of pregnancy, and any associated symptoms can all help determine the cause of vaginal bleeding in pregnancy. While vaginal bleeding in pregnancy does not signify a problem with the pregnancy, women who experience bleeding during pregnancy should always be evaluated by a doctor.

Causes of vaginal bleeding in pregnancy include miscarriage, an abnormal location of the placenta, ectopic pregnancy, cervical infection or polyp, and premature labor. Chronic medical conditions and medication use can also be related to vaginal bleeding during pregnancy.

What diagnostic tests are used to evaluate abnormal vaginal bleeding?
A woman who has irregular menstrual periods requires a physical examination with a special emphasis on the thyroid, breast, and pelvic area. During the pelvic examination, the physician attempts to detect cervical polyps or any unusual masses in the uterus. A Pap smear is also done to rule out cervical cancer. While the Pap smear is being obtained, samples might be taken from the cervix to test for the presence of infections such as chlamydia or gonorrhea.

A pregnancy test is routine if the woman is premenopausal. A blood count may be done to rule out a low blood count (anemia) resulting from excessive blood loss. If something in the patient's (or her family's) medical background or physical examination raises a doctor's suspicion, tests to rule-out certain blood clotting disorders may be done. Sometimes, a blood sample will be tested to evaluate thyroid function, liver function, or kidney function abnormalities. A blood test for progesterone levels or daily body temperature charting may be recommended to verify that the woman ovulates. If the doctor suspects that the ovaries are failing, such as with menopause, blood levels of follicle-stimulating hormone (FSH) may be tested. Additional blood hormone tests are done if the doctor suspects PCO or if excessive hair growth is present.

A pelvic ultrasound is often performed based on the woman's medical history and pelvic examination. If a woman does not adequately respond to medical treatment, if she is over age 40, or if she has persistent vaginal bleeding between her periods, a sampling of the lining of her uterus (termed endometrial sampling or endometrial biopsy) is analyzed. Endometrial sampling helps to rule out cancer or precancer in the uterus, or it can confirm a suspicion that a woman is not ovulating.

How is irregular vaginal bleeding treated?
Treatment for irregular vaginal bleeding depends on the underlying cause. After the cause is determined, the doctor decides if treatment is actually necessary. Sometimes, all that is needed is for dangerous causes to be ruled out and to determine that the irregular vaginal bleeding does not bother the woman enough to warrant medication or treatment. If thyroid, liver, kidney, or clotting problems are discovered, treatment is directed toward these conditions.

Medications for treatment of irregular vaginal bleeding depend on the cause. Examples are described below:

If the cause of the bleeding is lack of ovulation (anovulation), doctors may prescribe either progesterone to be taken at regular intervals, or an oral contraceptive, which contains progesterone, to achieve a proper hormonal balance. Such treatment dramatically decreases the risk of uterine cancer in women who do not ovulate.

If the cause of irregular vaginal bleeding is a precancerous change in the lining of the uterus, progesterone medications may be prescribed to reduce the buildup of precancerous uterine lining tissues in an attempt to avoid surgery.

When a woman has been without menses for less than 6 months and is bleeding irregularly, the cause may be menopausal transition. During this transition, a woman is sometimes offered an oral contraceptive to establish a more regular bleeding pattern, to provide contraception until she completes menopause, and to relieve hot flashes. A woman who is found to be menopausal as the cause of her irregular bleeding should also receive menopause counseling. (For more information about menopause treatment, see the Menopause article.)

If the cause of irregular vaginal bleeding is polyps or other benign growths, these are sometimes removed surgically to control bleeding because they cannot be treated with medication.

If the cause of bleeding is infection, antibiotics are necessary. Bleeding during pregnancy requires urgent evaluation by an obstetrician. Endometriosis can be treated with medications and/or surgery (such as laparoscopy). (For more information about the treatment of endometriosis, see the Endometriosis article.)

Sometimes, the cause of excessive bleeding is not apparent after completion of testing (dysfunctional uterine bleeding). In these cases, oral contraceptives can improve cycle control and lessen bleeding.

If bleeding is excessive and cannot be controlled by medication, a surgical procedure called dilation and curettage (D&C) may be necessary. In addition to alleviating the excessive bleeding, the D&C provides additional information that can rule out abnormalities of the lining of the uterus.

Occasionally, a hysterectomy is necessary when hormonal medications cannot control excessive bleeding. However, unless the cause is pre-cancerous or cancerous, this surgery should only be an option after other solutions have been tried.

Many new procedures are being developed to treat certain types of irregular vaginal bleeding. For example, studies are underway to evaluate techniques that selectively block the blood vessels involved in the bleeding. These newer methods may be less complicated options for some patients and as they are further evaluated they will likely become more widely available.

Vaginal Bleeding At A Glance

• Normal vaginal bleeding is the periodic blood that flows as a discharge from the woman's uterus.
• Normal vaginal bleeding is also called menorrhea. The process by which menorrhea occurs is called menstruation.
• In order to determine whether bleeding is abnormal, and its cause, the doctor must answer 3 questions: Is the woman pregnant? What is the pattern of the bleeding? Is she ovulating?
• Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding.
• There are many causes of abnormal vaginal bleeding that are associated with irregular ovulation.
• A woman who has irregular menstrual periods requires a physical examination with a special emphasis on the thyroid, breast, and pelvic area.
• Treatment for irregular vaginal bleeding depends on the underlying cause. After the cause is determined, the doctor decides if treatment is actually necessary.