Vaginal Bleeding - Abnormal
Vaginal Bleeding - Abnormal
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DefinitionMenstrual bleeding is abnormal and excessive when any of the following occur:
On a practical level, however, if a woman feels that the amount of bleeding is excessive or heavier than her normal periods, she should discuss this with her doctor. An increase of two or more tampons or pads per day or an increase in duration of 3 or more days is significant General Information
Caution - Pregnancy
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If not, see these topics
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When to Call Your Doctor |
Call 911 Now (you may need an ambulance) If |
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Call Your Doctor Now (night or day) If |
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Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If |
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Call Your Doctor During Weekday Office Hours If |
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Self Care at Home If |
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HOME CARE ADVICE |
Mild Vaginal Bleeding
Pregnancy test, when in doubt:
If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
Follow the instructions included in the package.
Spotting after a Procedure or Pelvic Exam: The cervix bleeds easily and even an internal exam, Pap smear, or biopsy of the cervix can cause some spotting. This spotting should subside within 24-72 hours.
Spotting After First Intercourse: Mild bleeding or spotting with first intercourse is common. It should stop within 48 hours and not recur.
Iron and Anemia: Heavy periods are the most common cause of iron deficiency anemia in women of childbearing age. Women with heavy periods should eat a diet rich in iron or take a daily multivitamin pill with iron.
Call Your Doctor If:
Pregnancy test is positive
You have difficulties with the home pregnancy test
Bleeding becomes worse
You become worse
Irregular Vaginal Bleeding while Using Birth Control Medicine
Spotting Between Periods and Taking Birth Control Pills: Breakthrough bleeding or spotting is common with most current birth control pills, especially during the first three pill pack cycles.
Spotting Between Periods and You Forgot to Take a Birth Control Pill:
Missing a pill may cause breakthrough bleeding or spotting.
If you ever forget to take more than one pill during a month, then you should use a "back-up" contraceptive method (e.g., condom) until you start the next pill pack.
Irregular bleeding and You are Using Implanon or Depo-Provera: Irregular bleeding is a common side effect. It may include heavier, lighter, more frequent or less frequent bleeding than your normal periods.
Irregular bleeding and You are using the Birth Control Patch: Breakthrough bleeding or spotting is common with current birth control patches, especially during the first 3 cycles (months).
Irregular Bleeding and You are Using the Vaginal Contraceptive Ring (i.e., NuvaRing): Breakthrough bleeding or spotting is not common with the vaginal contraceptive ring (i.e., NuvaRing). However, it can occur especially during the first 1 or 2 months of use (first 2 cycles).
Diary: Keep a record of the days you have any bleeding or spotting.
Call Your Doctor If:
Irregular bleeding occurs more than two cycles (2 months)
Bleeding becomes worse
You become worse
Taking Birth Control Pills and Missed One or More Pills
Birth Control Pills - MISSED 1:
If you forget to take a pill, take it as soon as you remember. Then take the next one on schedule. This may mean you take 2 pills in one day.
If you ever forget to take more than 1 pill for a month, then you should use a "back-up" contraceptive method (condom and foam) until you start the next pill pack.
Birth Control Pills - MISSED 2:
If you forget to take 2 pills, then take 2 pills the next two days. Then take the next one on schedule.
Never take more than 2 pills in one day (Reason: nausea and vomiting are side effects of too much hormone from the pills).
You must use a "back-up" contraceptive method (condom and foam) until you start the next pill pack.
And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.
Updated:  
March 22, 2017