Women's health conditions

Bleeding in the vagina becomes abnormal if you have:

• Irregular periods 
• Bleeding after menopause 
• Bleeding or spotting after sex
• Heavy bleeding during your period  
• Bleeding or spotting between periods

Bleeding during your menstrual cycle is normal and should last up to eight days. 

Some causes include: 

• Miscarriage 
• Ectopic pregnancy
• Bleeding disorders
• Fibroids and polyps
• Certain types of cancer
• Problems with ovulation 
• Problems linked to birth control 
• When the endometrium grows into the wall of the uterus (womb)

If you have abnormal vaginal bleeding, your health care team will ask you to make an appointment. They will ask about your medical history, previous menstrual cycles and check for common problems in your age group. 

They may also do a physical exam, blood tests, pregnancy tests and sexually transmitted infection (STI) tests. These check blood count and hormone levels, and help to rule out possible causes. 

Based on your symptoms and age, you may need more tests. 

If you have abnormal vaginal bleeding, your doctor will try to treat you with one of the following medications: 

• Tranexamic acid
• Hormonal birth control method 
• Nonsteroidal anti-inflammatory drugs 
• Antibiotics (medications that help treat infections) 
• Gonadotropin-releasing hormone (GnRH) agonists
• Special medications if you have a bleeding disorder

If medication is unsuccessful, your doctor will talk with you about other types of care. These may include surgery, based on your medical conditions, age and future pregnancy plans. Types of surgery include: 

• Hysterectomy 
• Myomectomy
• Endometrial ablation
• Uterine artery embolization 

This removes the lining of the uterus and stops and/or lessens bleeding. After surgery, pregnancy is unlikely, but can happen. 

If pregnancy does happen, it can lead to serious complications and may be life threatening. It's necessary to use a birth control method until you complete menopause.

This blocks blood vessels in the uterus and stops the blood flow that fibroids need to grow. 

This removes the fibroids and not the uterus. 

Your doctor will only do this surgery if other treatments have been unsuccessful. Your doctor removes your uterus. This means you won't be able to get pregnant and you won't have a period. 

Abnormal vaginal discharge is any change in liquid coming out of the vagina, including color, odor, amount or consistency from what you usually see. Normal discharge is clear and white and doesn't have a noticeable odor, but everyone’s body is different.

A certain amount of odor is normal, but if you feel the need to cover it up, schedule an appointment with your doctor. Don't use sprays, deodorants or douches, as they can make problems worse.

When something disrupts the natural balance of bacteria in the vagina, abnormal discharge occurs. Two common infections include:

• Yeast infection
• Bacterial vaginosis

Sometimes there is an overgrowth of yeast in the vagina. Lubricants, spermicides, antibiotics or pregnancy can cause this to happen. You'll likely have itching and/or burning.

To treat a yeast infection, your doctor may give you anti-yeast medication or a prescription antibiotic pill. 

This is an overgrowth of bacteria in the vagina. Symptoms include high amounts of discharge and a fishy odor. To treat bacterial vaginosis, your doctor may give you antibiotics by mouth or inserted into the vagina. 

Pelvic pain is pain in the pelvic area. This pain can be long-term, appear and disappear, or be constant. A woman’s menstrual cycle causes normal pelvic pain. 

Long-term pelvic pain is consistent and can happen before or after eating, while urinating and during sex.

During your visit with your doctor, mention your pelvic pain. Your doctor will ask about your medical history and do a pelvic exam. Your doctor may also ask for more testing to find the cause. In some cases, your doctor may refer you to a gastroenterologist or urogynecologist. 

There are a number of treatments to help treat pelvic pain. They include: 

• Physical therapy, such as acupuncture, acupressure, or nerve stimulation
• Nutrition therapy (changing what you eat), such as vitamin B1 and magnesium
• Lifestyle changes, such as practicing good posture and regular exercise, among others
• Pain-relieving drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) are helpful, especially for dysmenorrhea (painful period cramps) 

If other methods don't help you, your doctor may suggest surgery to cut or destroy nerves to stop pain signals from reaching your tissue and organs.

Your results are “positive” if your Pap smear appears abnormal. A positive result doesn't mean you have cervical cancer. It means there is a presence of abnormal cells that could potentially become cancerous over time. 

The causes range in significance based on what cells your doctor finds. If you have an abnormal Pap smear, your doctor will do further testing to find out the cause and then work with you to create a care plan. 

Abnormal Pap smears are described with the following terms:

• ASC-US 
• LSIL 
• HSIL 
• ASC-H 
• AGC 

ASC-US stands for atypical squamous cells of undetermined significance. This means there are changes in your cervical cells. This is usually a sign of HPV infection. HPV is a virus that causes cervical cancer. This is the most common abnormal Pap test result. 

Learn more about HPV.

LSIL stands for low-grade squamous intraepithelial lesion. A lesion is a sore or infected part of the body. This means cervical cells show mildly abnormal changes, usually caused by HPV infection. This often goes away on its own.

HSIL stands for high-grade squamous intraepithelial lesion. This means there has been a serious change to your cervix (lower part of the uterus). It typically links to precancer and cancer.

ASC-H stands for atypical squamous cells and cannot exclude HSIL. This means the changes in the cervical cells raise concern for the presence of HSIL. 

AGC stands for atypical glandular cells. This means changes in the glandular cells raise concern for precancer or cancer. Glandular cells make up the tissue covering the inner canal of the cervix. Glandular cells are also inside the uterus. 

Your doctor will do more tests based on your age, medical history, first screening test results and chances of getting cervical cancer.

These tests can include:

• HPV typing
• Reflex testing
• Repeat testing
• Endometrial sampling
• Colposcopy, biopsy (taking a sample of tissue from your body and testing it) and endocervical sampling