Vaginal Bleeding
(Menstruation)

Medical Author: Carolyn Janet Crandall, MD, MS, FACP
Medical Revising Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

• What is normal vaginal bleeding (menstruation)?
• What is abnormal vaginal bleeding?
  • Is the woman having abnormal vaginal bleeding during pregnancy?
  • What is the pattern of the abnormal vaginal bleeding?
  • Is the woman ovulating?
• What conditions cause abnormal vaginal bleeding in women who are ovulating regularly?
  • Excessively heavy vaginal (menstrual) bleeding (menorrhagia)
  • Menstrual periods that are too frequent (polymenorrhea)
  • Irregular vaginal bleeding; menstrual periods at irregular intervals (metrorrhagia)
  • Decreased amount or duration of menstrual flow (hypomenorrhea)
  • Bleeding between menstrual periods
• What conditions cause abnormal vaginal bleeding in women who are not ovulating regularly or vaginal bleeding after menopause?
• What causes abnormal vaginal bleeding during or after sexual intercourse?
• What causes abnormal vaginal bleeding during pregnancy?
• What tests are used to evaluate abnormal vaginal bleeding?
• How is irregular or abnormal vaginal bleeding treated?
• Vaginal Bleeding At A Glance

What is normal vaginal bleeding?

Normal vaginal bleeding is the periodic blood that flows as a discharge from the woman's uterus. Normal vaginal bleeding is also called menorrhea. The process by which menorrhea occurs is called menstruation.

Normal vaginal bleeding occurs as a result of cyclic hormonal changes. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle. The ovary, or female gonad, is one of a pair of reproductive glands in women. They are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female hormones. During each monthly menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a Fallopian tube to the uterus. Unless pregnancy occurs, the cycle ends with the shedding of part of the inner lining of uterus, which is menstruation. Although it is actually the end of the physical cycle, the first day of menstrual bleeding is designated as "day 1" of the menstrual cycle in medical jargon.

The time of the cycle during which menstruation occurs is referred to as menses. The menses occurs at approximately 4 week intervals, representing the menstrual cycle.

Menarche is the time in a girl's life when menstruation first begins. Menopause is the time in a woman's life when the function of the ovaries ceases. The average age of menopause is 51 years old.

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