When Should I Contact My Doctor About Abnormal Bleeding?

It’s natural to be alarmed when you see blood, whether your child scrapes their knee or you slice your finger while trimming the asparagus. However, women who menstruate are accustomed to seeing blood appear in regular cycles. So, what does it mean when you notice you’re bleeding vaginally — but you’re not having your period?

Understandably, panic may set in when you notice bleeding of this sort, but it helps to know when a bit of bleeding is considered perfectly normal and when you should have it checked out by your OB/GYN. 

The talented and caring team at Southdale OB/GYN is dedicated to supporting your health and educating you about your body, a chronic condition you may be managing together, or simply answering a question about women’s health. 

When is vaginal bleeding considered something to worry about?

Women are used to bleeding during their menstrual period each month, and sometimes even a bit between periods, but other things can trigger mild bleeding. The question is, how do you determine whether there’s cause for concern or not? 

Some causes of intermittent light bleeding that are not serious include:

• Hormonal birth control methods, like low-dose birth control pills and the IUD 
• Endometriosis
• Pregnancy
• Fertility treatments, such as IVF
• Perimenopause (the time that precedes menopause)

Several of these instances are at times when your hormonal levels are shifting, like when you take hormonal birth control or are pregnant. But there are things to keep in mind and questions to ask yourself about your bleeding that indicate you should get checked out by your Southdale OB/GYN provider. 

Even if bleeding is minor and you think you know why it has happened, it’s always a good idea to make an appointment with your OB/GYN just to be safe and put your worries to rest. 

When vaginal bleeding may indicate something more serious

Two indicators that point to potential problems with vaginal bleeding are quantity and duration. Prolonged bleeding and losing lots of blood are worthy of a visit to the doctor and could be linked to something concerning. 

1. When spotting is frequent

A bit of spotting can be normal between periods, but if it’s happening often, the bleeding could be a sign of an infection or a symptom of endometriosis or fibroids, which need to be addressed medically. In the case of fibroids, we may take a “wait and see” attitude, but it’s best to have the situation checked out. 

In less common instances, lots of spotting can be a cancer symptom.

2. Heavy bleeding, especially if you’re pregnant

It’s one thing to bleed more during the heavier bleeding days of your period, but if this is our norm and happens at some other time, seek care immediately. It could mean that you have an infection or inflammation of the uterus (endometritis) or cervix (cervicitis), a hormonal imbalance, or it could be related to a medication you’re taking. Blood thinners are an example of a commonly prescribed medication that leads to bleeding. 

An injury to your uterus or vaginal opening or a medical condition like pelvic inflammatory disease, diabetes, and gynecologic precancers and cancers can also cause unusual bleeding.

It is an urgent matter if you experience either spotting that transitions to heavy bleeding or heavy bleeding out of nowhere if you’re pregnant. In this case, you should see your Southdale OB/GYN immediately, or if it’s after hours, go to the nearest emergency department. Seek care also if pain or cramping accompanies the bleeding. 

3. Bleeding if you’re postmenopausal

Whether you take hormone therapy or not, seek care if you’re bleeding during menopause. Bleeding is worrisome if you take cyclic hormone therapy (when you take estrogen daily, with progestin added 10-12 days a month) or continuous hormone therapy (when you take a low dose of estrogen and progestin each day). You should also make an appointment with your provider if you have bleeding and aren’t on hormone therapy. 

When you visit us for unexplained bleeding, we investigate its source — for example, whether it’s vaginal, uterine, or ovarian. We consider your health history and current condition since certain medications and health conditions can cause bleeding. Bloodwork and other testing, such as ultrasound testing, may also be necessary to rule out cancer. 

The final verdict with vaginal bleeding is: It’s best to check it out. 

Call our Edina or Burnsville office to schedule an appointment with one of our expert providers, or book one online.