Vaginal Bleeding Between Periods

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What to Expect at your Health Care Provider's Office

The medical history will be obtained and a physical examination performed.

Medical history questions documenting vaginal bleeding between periods detail may include:

• Time pattern
  • When did this bleeding between periods begin?
  • Does it occur consistently, such as every month?
  • When (during the course of a menstrual cycle) does this bleeding begin?
  • How long does the in-between bleeding last?
• Quality
  • Is the bleeding heavy?
  • How many tampons or pads are required?
  • Do cramps accompany the bleeding?
• Aggravating factors
  • What makes it worse?
  • Does increased physical activity make the bleeding worse?
  • Does intercourse bring on the bleeding?
  • Is increased stress associated with the bleeding?
• Relieving factors
  • Does anything relieve or prevent it?
• Other symptoms
  • What other symptoms are also present?
  • Do you have abdominal pain or cramps?
  • Increased bruising elsewhere on the body?
  • Do you have any difficulty, pain or burning with urination?
  • Is there bloody urine or blood in the stools?
• Other important information
  • Are you pregnant?
  • Have you had a miscarriage or abortion?
  • Have you had a D and C?
  • What medications are being taken?
  • Are tampons used? What kind? What size?
  • At what age did menstruation start?
  • Have there been normal periods without bleeding between in the past?
  • Is sexual activity occurring?
  • Is there a history of sexually transmitted disease?
  • Is birth control being used? What kind?
  • Have there been any injuries?
  • Have there been any medical or surgical treatments?

A thorough menstrual history will be obtained and a physical examination performed with an emphasis on the pelvic area. Uterine blood loss can be estimated if the patient knows how many sanitary napkins or tampons were used during a period.

Diagnostic tests that may be performed include:

• Urine pregnancy test
• Cervical cultures for sexually transmitted diseases
• Blood tests for thyroid and ovarian functions.
• Pap smear (if bleeding is inactive)
• Endometrial biopsy
• Pelvic ultrasound