Abnormal Vaginal Bleeding: When to Seek Medical Attention - Obstetrics and Gynecology

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Abnormal vaginal bleeding can be a concerning symptom for many women, and understanding when to seek medical attention is crucial for maintaining reproductive health. Based on your description, it appears that you have a history of abnormal bleeding, which was previously attributed to a cervical polyp that was removed. While it is reassuring that your recent Pap smear results were normal, the recurrence of bleeding warrants careful consideration.


When to Seek Medical Attention
1. Duration of Bleeding: If you experience bleeding that lasts longer than a week, it is advisable to consult a healthcare provider. In your case, since the bleeding has persisted for about a week, it would be prudent to schedule an appointment with your gynecologist.

2. Volume of Bleeding: You mentioned that the bleeding is significant enough to notice on toilet paper and occasionally on your underwear. If the amount of bleeding is heavier than what you typically experience during your menstrual period, or if you are soaking through pads or tampons in a short period, this is a clear indication to seek medical care.

3. Associated Symptoms: Pay attention to any additional symptoms that accompany the bleeding. These may include:
- Severe abdominal or pelvic pain
- Fever or chills
- Unusual discharge (especially if it has a foul odor)
- Dizziness or fainting spells
If you experience any of these symptoms, it is important to seek medical attention promptly.

4. Changes in Your Cycle: Since you have a history of abnormal bleeding, any changes in your menstrual cycle, such as irregularities in timing or flow, should be evaluated by a healthcare professional.
5. Previous Medical History: Given your history of cervical polyps, it is essential to monitor any new bleeding closely. While it may not be related, any recurrence of bleeding after a previous diagnosis should be investigated to rule out any new or recurring issues.


Possible Causes of Abnormal Bleeding
Abnormal vaginal bleeding can arise from various causes, including but not limited to:
- Hormonal Imbalances: Fluctuations in hormone levels can lead to irregular bleeding. This is common during puberty, perimenopause, or due to conditions like polycystic ovary syndrome (PCOS).

- Uterine Fibroids or Polyps: These benign growths can cause heavy or irregular bleeding.

- Infections: Pelvic inflammatory disease (PID) or sexually transmitted infections (STIs) can lead to abnormal bleeding.

- Endometriosis: This condition can cause bleeding between periods and is often accompanied by pelvic pain.

- Cervical or Uterine Cancer: Though less common, any new or unusual bleeding should be evaluated to rule out malignancies.


Conclusion
In summary, given your history and the current symptoms of abnormal bleeding, it is advisable to consult your gynecologist for a thorough evaluation. They may recommend a pelvic examination, ultrasound, or further testing to determine the underlying cause of your symptoms. Early intervention can help address any potential issues and provide peace of mind. Remember, it is always better to err on the side of caution when it comes to your health.