Abnormal vaginal bleeding is any vaginal bleeding unrelated to your period. 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.
Vaginal bleeding during your period (menstruation) occurs every 21 to 35 days when the uterus sheds its lining, marking the start of a new reproductive cycle.
Menstrual periods may last for just a few days or up to a week. Bleeding may may be heavy or light. Menstrual cycles tend to be longer for teens and for women nearing menopause. Menstrual flow may also be heavier at those ages.
June 15, 2021
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.
Kaunitz AM. Approach to abnormal uterine bleeding in nonpregnant reproductive-age women. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
Kaunitz AM. Differential diagnosis of genital tract bleeding in women. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
Zacur HA. Managing an episode of severe or prolonged uterine bleeding. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
AskMayoExpert. Abnormal uterine bleeding: Premenopausal women (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
AskMayoExpert. Postmenopausal bleeding. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
Kliegman RM, et al. Gynecologic history and physical examination. In: Nelson Textbook of Pediatrics. 21st ed. Philadelphia, Pa.: Elsevier; 2020. http://www.clinicalkey.com. Accessed April 18, 2019.
Your menstrual cycle. Womenshealth.gov. https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle. Accessed April 18, 2019.
Goodman A. Postmenopausal uterine bleeding. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
Gonorrhea — CDC fact sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm. Accessed April 18, 2019.
Frequently asked questions. Pregnancy FAQ090. Early pregnancy loss. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Early-Pregnancy-Loss. Accessed April 18, 2019.
Walls RM, et al., eds. Vaginal bleeding. In: Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed April 18, 2019.
Fritz MA, et al., eds. Abnormal uterine bleeding. In: Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://www.ovid.com/site/index.jsp. Accessed March 7, 2016.
Fritz MA, et al., eds. Oral contraception. In: Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://www.ovid.com/site/index.jsp. Accessed March 7, 2016.