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Vaginal bleeding

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Abnormal vaginal bleeding is any vaginal bleeding unrelated to normal menstruation. This type of bleeding may include spotting of small amounts of blood between periods — often seen on toilet tissue after wiping — or extremely heavy periods in which you soak a pad or tampon every one to two hours for two or more hours.

Normal vaginal bleeding, or menstruation, occurs every 21 to 35 days when the uterus sheds its lining, marking the start of a new reproductive cycle. A menstrual period may last for just a few days or more than a week. Your flow may be heavy or light and still considered normal. Cycles tend to be longer before age 20 and after age 40, and your flow may be heavier at those ages.

References 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.South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=52. Accessed Mar. 4, 2013.Schmitz G, et al. Genitourinary emergencies in the nonpregnant woman. Emergency Medicine Clinics of North America. 2011:29;621.Goodman AK. Initial approach to the premenopausal woman with abnormal uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.AskMayoExpert. What are the most common causes of abnormal uterine bleeding? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.AskMayoExpert. What are the most common causes of postmenopausal vaginal bleeding? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.Casper RF. Clinical manifestations and diagnosis of menopause. http://www.uptodate.com/home. Accessed March 10, 2013.Goodman AK. Postmenopausal uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.Zacur HA. Managing an episode of severe or prolonged uterine bleeding. http://www.uptodate.com/home. Accessed March 4, 2013.Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed March 5, 2013.Tsai MC, et al. Office diagnosis and management of abnormal uterine bleeding. Clinical Obstetrics and Gynecology. 2012;55:635.Paradise J. Evaluation of vaginal bleeding in children and adolescents. http://www.uptodate.com/home. Accessed March 12, 2013.Hickey M, et al. Unscheduled bleeding in continuous combined hormone therapy users. Maturitas. 2011;70:400.Fritz MA, et al., eds. Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=booktext&D=books&AN=01437507$&XPATH=/PG(0). Accessed March 12, 2013.Goodman AK. Overview of causes of genital tract bleeding in women. http://www.uptodate.com/home. Accessed March 22, 2013.Frequently asked questions. Gynecologic problems FAQ162. Perimenopausal bleeding and bleeding after menopause. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq162.pdf?dmc=1&ts=20130329T1216499168. Accessed March 22, 2013.General information about vaginal cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/vaginal/Patient/page1. Accessed March 21, 2013.Shah SH, et al. Uterine sarcomas: Then and now. American Journal of Roentgenology. 2012;199:213.Gonorrhea - CDC Fact Sheet. Centers for Disease Control and Prevention. http://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm. Accessed March 21, 2013.var shareUrl=encodeURIComponent(window.location);var shareTitle=encodeURIComponent(document.title);

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