Vaginal and bleeding

Vaginal bleeding that is not caused by the menstrual bleeding can indicate a serious illness but can also be harmless.


What are the causes of vaginal bleeding?

Mother hormones: In girls, bleeding can be caused by the mother’s hormones.

This occurs only in newborn girls, since the maternal hormones can stimulate the uterine lining of the child during pregnancy.
A few weeks after birth, the hormones are eliminated and bleeding does not recur.

Foreign objects: Little girls sometimes put small toys in the vagina (as a game or while trying to explore their own bodies) and do not remove them again.
This can lead to injuries and bleeding.
In women, the foreign body is usually a forgotten tampon.

Sexually transmitted diseases: There are many symptoms of STDs, for example:

  1. bleeding after the menstrual cycle;
  2. vaginal mucus discharge;
  3. swelling, ulcer, rash or a nodule that appears in the area of the vulva, vagina or anus;
  4. Pain during sexual intercourse;
  5. Pain when urinating.

The most common infections that cause vaginal bleeding are:

Polyp on the cervix – A polyp is an abnormal structure connected to the uterine epithelium via a stalk.
Polyps are small malformations that can develop on the cervix or inside the uterine cavity.
Usually, the doctor discovers it during an examination.
Polyps can be removed, they are usually not malignant.

Some tumors, such as cervical cancer, can cause bleeding. Often other symptoms appear, for example, pain during sexual intercourse.

Vaginal bleeding during the menstrual cycle

For a few days a month, there is bleeding from the vagina.
The amount of loss can vary between menstrual cycles and varies from woman to woman.
Some women lose less and darker blood, while others lose more blood, which has a bright red color.
Sometimes blood clots are also flushed out, especially if the bleeding is heavy.
The normal amount of blood during a menstrual period is between 20 and 60 ml. Menstrual bleeding can last up to eight days, but the average is five days.

The bleeding is strongest in the first two days.
Abdominal pain occurs quite frequently, but is not a sign of a serious illness.

Heavy menstrual bleeding
This is a common phenomenon. The amount of blood lost is difficult to measure, usually referred to as heavy menstrual bleeding when blood loss exceeds 80 ml per cycle.
Menstrual bleeding is considered heavy if:

  1. the tampon must be changed every two hours;
  2. blood flow lasts more than 7 days;
  3. blood clots are flushed out with the blood;
  4. normal everyday life is thereby impaired.

Causes of bleeding in pregnancy

First trimester
of pregnancy 
A slight bleeding in the first trimester of pregnancy does not always indicate a problem.
It may be due to:

  • Sexual intercourse
  • infection,
  • normal blood loss due to implantation of the egg in the uterus,
  • Hormonal changes.

Serious causes of bleeding in the first three months of pregnancy include:

  • Miscarriage: Almost all women who have an abortion experience bleeding before a miscarriage.
  • ectopic pregnancy, which can cause bleeding and cramping.
  • Molar pregnancy, in which a fertilized but non-viable egg implants in the uterus. The embryo does not develop and therefore the pregnancy cannot be carried to term.

Third trimester
of pregnancy The changes in the cervix can lead to bleeding, especially after sexual intercourse.

Outlet of the mucus plug
If the mucus plug, which is located in the cervix during pregnancy, comes loose, it is a sign that the cervix is ready to give birth.
The mucus plug goes off along with some blood.
The bleeding is caused by the rupture of the fragile capillaries in the cervix.
This bright discharge can occur a few days before labor or during childbirth.

Placental detachment – a serious complication of pregnancy, in which the placenta partially or completely detaches from the uterine wall. Placental detachment usually causes:

Placental detachment can also occur without symptoms and without bleeding.

Low-lying placenta (or placenta previa) – when the placenta is located in the lower part of the uterus, near or above the cervix.
The bleeding in a deep-seated placenta can be very severe and pose a danger to mother and child.
In most cases, the doctor recommends a caesarean section.

Vasa previa – a complication of pregnancy in which the blood vessels of the placenta or navel pass through the membranes that cover the cervix.

Normally, the blood vessels are enclosed by the umbilical cord and placenta.
If the amniotic sac bursts, these vessels can rupture and cause bleeding.
The child can lose a dangerous amount of blood, which can even lead to death.

Vasa previa is very difficult to diagnose before birth, but in certain cases it can be detected by Doppler sonography to control the blood flow passing through the opening of the uterus above the cervix.
In the case of vasa previa, an emergency caesarean section should be performed.

Bleeding after childbirth

The weekly flow after birth is also called lochia and is normal.
These are fragments of the uterine lining (decidua).
The discharge is intensely red in the first few days, but over time the color changes and becomes pink, yellowish and finally white.
The amount becomes smaller and smaller and disappears within 3 weeks. Some women notice discharge only over 2 weeks.

Other causes of

Bleeding during ovulation
During ovulation, slight bleeding or discharge of bloody mucus may occur.
The cause is a drop in the level of estrogen in the blood, which precedes the peak of ovulation.
The blood is usually due to hormonal fluctuations.

Bleeding after sexual intercourse is also called postcoital spotting.
They can occur because the cervix is sore and inflamed.
Therefore, bleeding after sexual intercourse may occur more frequently.
Some of the causes of frequent bleeding during sexual intercourse are:

  • infections such as chlamydia,
  • hormonal changes,
  • vaginal dryness,
  • Lesions of the cervix.

Dark bleeding

Brown blood or spotting can be caused by:

  • Stress: may cause irregular menstrual periods.
  • Anorexia, bulimia and obesity – can cause weakness and dark discharge.
  • Birth control pill or vaginal ring – Sometimes mild bleeding may occur in the first few months after taking the birth control pill for the first time.
    They usually stop after a few months.
  • Incorrect insertion of the spiral
  • Organic diseases such as ovarian cysts, polyps and endometriosis.

Diagnosis of bleeding

When you go to the doctor, you have to tell him the following information:

  • type of bleeding,
  • amount of discharge,
  • whether blood clots are present,
  • whether the discharge smells bad.

The doctor must know about taking the following information:

  • Medicines
  • herbal products.

Sometimes natural products can interact with prescription medications, such as oral contraceptives.

The doctor asks for information about sex life to see if the patient might have an infection.
It is important to know the type of contraceptives used. For example, a condom can protect against transmissible STDs.

The gynecologist can examine the vagina by inserting two fingers. This allows him to determine the size of the uterus and whether it is sore.
The doctor may use something called a speculum to see inside the vagina.
With a speculum you can see vaginal discharge and with rods you can take a sample (vaginal smear).
The removed tissue is sent to a laboratory for analysis to determine if the cause of the discharge is infection.

The gynecologist may prescribe further examinations or perform an ultrasound.

Bleeding from the anus

Rectal bleeding is called hematochecia, which means the leakage of fresh blood from the anus, often together with the stool.

It usually occurs suddenly and is due to an intestinal disorder.
Although the bleeding may originate from the rectum, in some cases it may originate in other areas of the lower and upper gastrointestinal tract (especially the colon).
Bleeding can be observed with different forms of stool:

  • black stool or tarry stool (melena),
  • bright red chair,
  • Blood on the toilet paper.

The possible consequences of bleeding are symptoms such as:

Causes of bleeding from the anus

rhagades: rhagades are a common cause of rectal bleeding.
The wall of the anus canal tears due to constipation, which can lead to bleeding and also severe pain during bowel movements.

Hemorrhoids: Hemorrhoids are dilated blood vessels or veins in the canal.
The veins swell for various reasons:

  • Poor diet, such as too much nuts (nuts, almonds, etc.) or cereals.
  • Tension of the anus during the passage of hard or dry stools, causing anus pain or bleeding.

However, most often bleeding from hemorrhoids is moderate and does not cause:

Fistula: An fistula is an unnatural canal that extends from the rectum to the skin around the anus.
It usually contains a yellowish liquid (pus), but sometimes it can bleed.
Most often, a fistula is related to chronic inflammation of the digestive tract and causes:

DiverticulosisDiverticulosis is a disease in which diverticulum-shaped protuberances form in the large intestine (protrusions of the intestinal mucosa).
These protuberances are essentially caused by a weakness of the colon wall and manifest themselves in:

  • mild rectal bleeding,
  • foul-smelling stool.

Proctitis and colitis are diseases that occur as a result of inflammation or ulcer in the rectum, colon, or both.
If the inflammation is limited to the rectum, the disease is called proctitis, if it spreads to the large intestine, colitis.

Symptoms include

  • Cramps
  • diarrhoea (diarrhoea),
  • urge to defecate (the feeling of having to empty the bowel immediately),
  • Bleedings.

Polyps and cancer: Polyps are benign tumors in the colon that reach large dimensions and can cause bleeding.
Some types of polyps develop colon cancer and cause:

  • intense red bleeding,
  • abdominal or pain,
  • Diarrhea or constipation.

Rectal prolapse: This disorder occurs due to a weakening of rectal supporting tissue, especially in the elderly.
The person may feel an abnormal bulge on the buttocks as it dries off.
Symptoms of rectal prolapse also include rectal bleeding.

Diagnosis of bleeding from the anus

In case of bleeding from the anus, it is necessary to consult a proctologist, as they can be a sign of serious diseases.
First, the area is examined to detect hemorrhoids or rhagades.
If the cause of the bleeding cannot be clarified during the examination, a colonoscopy (colonoscopy) is indicated.

How to treat bleeding from the anus?

The therapy depends on the cause of the bleeding.
It can range from the use of simple, over-the-counter medicines and home remedies to surgery.

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