Heavy vaginal bleeding

Bleeding may arise from the vaginal tissue, cervix, or uterus. Hormone changes, irritation, infection such as Chlamydia, or changes related to Genitourinary Syndrome of Menopause can contribute. Cervical Dysplasia, Cervical Cancer, or Vaginal Cancer are less common possibilities that require clinical evaluation; bleeding does not identify which condition is present.

A clinician may ask whether bleeding follows sex, whether periods are involved, whether pregnancy is possible, and whether there is pain, discharge, dryness, fever, or dizziness. Assessment can include an examination, pregnancy test, infection testing, blood tests, or imaging.

Note when the bleeding began, how quickly protection becomes wet, whether there are clots, and whether you have pain, fever, unusual discharge, dizziness, or shortness of breath. Contact a clinician promptly for new, unexplained, recurrent, or post-sex bleeding. Use pads while monitoring flow if possible, and bring a list of medicines and contraception.

Do not put products inside the vagina to stop bleeding, and do not delay care to wait for a routine appointment if symptoms are escalating.

Go to emergency care for bleeding that is heavy and continuing, fainting, severe weakness, shortness of breath, severe pelvic or abdominal pain, confusion, or a fast heartbeat with feeling unwell. Bleeding with pregnancy possibility, fever, or one-sided pain also needs urgent assessment.

Where might this bleeding be coming from? Do I need an examination, pregnancy test, infection tests, blood tests, or imaging? Could dryness, cervical changes, or a medicine contribute? What should I do if the bleeding starts again?