Abnormal Vaginal Bleeding: Causes and When to Seek Help

Abnormal vaginal bleeding?

Hello Doctor, I have been taking oral contraceptive pills for about a year now, and recently I have experienced abnormal vaginal bleeding (not during my menstrual period).
I would like to ask: 1.
What factors could cause this issue? (I am also considering the possibility of urethral bleeding, as the bleeding is only a faint red color when wiping after urination, while the urine itself is normal in color.) 2.
In this situation, should I consult a urologist or a gynecologist? Additional information: I have been using different brands of oral contraceptives each month, but I always complete one entire pack before waiting seven days to start a different brand.
Could this be the reason for the abnormal vaginal/urethral bleeding? Thank you for your time in answering!

Meinv, 20~29 year old female. Ask Date: 2023/05/21

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause bleeding outside of menstruation are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, contraceptives, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, miscarriage, and breastfeeding, among others.
It is advisable to consult a gynecologist if symptoms persist or worsen to determine whether there is a hormonal imbalance or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2023/05/21

More Info

Abnormal vaginal bleeding can be a concerning issue for many women, and understanding its causes is crucial for determining when to seek medical help. Based on your situation, where you have been taking birth control pills for about a year and are experiencing abnormal bleeding, let's delve into the potential causes and the appropriate steps to take.

Causes of Abnormal Vaginal Bleeding
1. Hormonal Fluctuations: Birth control pills work by regulating hormones, but switching between different brands can lead to hormonal imbalances. Each brand may have different hormone levels, which can affect your menstrual cycle and lead to breakthrough bleeding or spotting between periods.

2. Missed Pills: If you have missed any doses or taken the pills inconsistently, this can disrupt your hormonal balance and result in abnormal bleeding.

3. Uterine or Cervical Issues: Conditions such as polyps, fibroids, or cervical erosion can cause abnormal bleeding. While these are less common, they should be considered, especially if the bleeding is persistent.

4. Infections: Sexually transmitted infections (STIs) or pelvic inflammatory disease (PID) can lead to abnormal bleeding. These conditions may also present with other symptoms like unusual discharge or pelvic pain.

5. Urinary Tract Issues: Since you mentioned the possibility of the bleeding being from the urinary tract, conditions such as urinary tract infections (UTIs) or kidney stones can cause blood in the urine, which might be mistaken for vaginal bleeding.

6. Pregnancy-Related Issues: Although you are on birth control, it’s important to rule out pregnancy, as breakthrough bleeding can occur in early pregnancy or due to complications like ectopic pregnancy.

When to Seek Help
Given your symptoms, it is advisable to consult a healthcare provider. Here are some guidelines on when to seek help:
- Persistent Bleeding: If the abnormal bleeding continues for more than a few days or becomes heavier, it’s essential to see a doctor.

- Associated Symptoms: If you experience additional symptoms such as pain, fever, or unusual discharge, seek medical attention promptly.

- Change in Urination: If the bleeding is associated with changes in urination, such as pain or changes in urine color, it may be necessary to see a urologist.

Which Specialist to See?
In your case, since you are experiencing abnormal vaginal bleeding, it would be best to start with a visit to a gynecologist. They can perform a thorough examination, including a pelvic exam, and may conduct tests to determine the cause of the bleeding. If they suspect that the bleeding may be related to urinary issues, they can refer you to a urologist for further evaluation.

Conclusion
In summary, abnormal vaginal bleeding can arise from various factors, particularly hormonal changes due to birth control pills. It’s crucial to monitor your symptoms and seek medical advice if the bleeding persists or is accompanied by other concerning symptoms. Consistency in taking your birth control pills and discussing any changes in your regimen with your healthcare provider can also help mitigate these issues. Remember, your health is paramount, and addressing these symptoms early can lead to better outcomes.

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