Normal bleeding (menstruation) is cyclical bleeding from the genital tract at interval of 28 days( range is 21 to 35 days) for 2 to 7 days.Abnormal vaginal bleeding happens to most women at some point of their lives. Bleeding can be abnormal if vaginal bleeding occurs:

• At times when period is not expected
• Heavy periods
• Light periods
• Early period
• Late periods
• After intercourse
• After menopause

Any change in pattern should be looked into by a specialist. There are many causes of abnormal bleeding which vary according to age.

In teenage the causes of abnormal bleeding are:

• Puberty menorrhagia
• PCOD
• Hormonal
• Clotting disorder

In reproductive age the causes of abnormal bleeding are :

• Pregnancy complications are first and foremost
• Others are mid cycle bleed due to ovulation
• PCOD
• Infections of genital tract
• Hormonal disorder
• Clotting disorder
• Uterine fibroids
• Polyp
• Emotional stress
• Post delivery or abortion
• One important cause of abnormal bleeding is cancer of genital tract. Cancer of cervix, uterus, ovary, vagina or urinary tract may also present as irregular bleeding.

Older age group the causes of abnormal bleeding are :

• Peri menopause
• Cancers are an important cause of bleeding in this age group

Any bleeding after menopause is very serious and should always be reported and evaluated.

Diagnosis of abnormal bleeding:

Personal, family history and detailed menstrual history is asked. Physical examination is done. Blood tests for counts, hormones and some other diseases of blood are done. Pregnancy test is also done.

Special tests to diagnose the underlying cause of abnormal bleeding:

• Ultrasound
• MRI
• Hysteroscopy
• Laparoscopy
• Endometrial Biopsy

Treatment of abnormal bleeding:

Talking of cancers, if evaluated and detected early cancers of female genital tract are treatable by surgical means. So the message is, do not ignore, delay and self diagnose irregular bleeding as it can cause delay in diagnosis and complicate matters. Pelvic organs are delicate and parameters of a women’s health. They need proper care and compassion of a qualified medical practitioner.