If you're pregnant, contact your doctor immediately if you notice vaginal bleeding.
In general, anytime you experience unexpected vaginal bleeding, consult your doctor. Whether or not vaginal bleeding is normal depends on your age and the circumstances.
Contact your doctor in the following situations:
- Postmenopausal women not taking hormone therapy should see a doctor if they experience vaginal bleeding.
- Postmenopausal women taking cyclic hormone therapy may experience some vaginal bleeding. A cyclic hormone therapy regimen — oral estrogen daily plus oral progestin for 10 to 12 days a month — can lead to bleeding that resembles a period (withdrawal bleeding) for a few days out of the month. If you have bleeding other than expected withdrawal bleeding, contact your doctor.
- Postmenopausal women taking continuous hormone therapy — a low-dose combination of estrogen and progestin daily — may experience light, irregular bleeding for the first six months. If bleeding persists longer or heavy bleeding begins, see your doctor.
- Girls who don't have any other signs of puberty or are younger than age 8 should have any vaginal bleeding investigated.
The following situations are likely normal, but talk to your doctor if you're concerned:
April 16, 2016
- Newborn girls may have some vaginal bleeding during the first month of life. Bleeding that's excessive or lasts longer should be checked out.
- Teenagers who have just begun having periods may experience irregular cycles during the first few years. In addition, many girls and women have light spotting for a few days before menstruating.
- Women starting birth control pills may experience occasional spotting the first few months.
- Women nearing menopause (perimenopause) may experience increasingly heavy or irregular periods. Ask your doctor about possible treatments to minimize your symptoms.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 128. Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstetrics and Gynecology. 2012;120:197.
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- AskMayoExpert. Abnormal uterine bleeding: Premenopausal women (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- AskMayoExpert. Postmenopausal bleeding. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Kliegman RM, et al. Gynecologic problems of childhood. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed March 2, 2016.
- Menstruation and the menstrual cycle fact sheet. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.html. Accessed March 7, 2016.
- Goodman A. Postmenopausal uterine bleeding. http://www.uptodate.com/home. Accessed March 1, 2016.
- Gonorrhea — CDC fact sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm. Accessed March 3, 2016.
- Frequently asked questions. Pregnancy FAQ090. Early pregnancy loss. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Early-Pregnancy-Loss. Accessed March 7, 2016.
- Marx JA, et al., eds. Gynecologic pain and vaginal bleeding. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed March 2, 2016.
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