Possible Causes of Abnormal Vaginal Bleeding After 14 Days - Obstetrics and Gynecology

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Abnormal vaginal bleeding lasting for 14 days can be concerning and may arise from various underlying causes. Given the description of your symptoms—consistent bleeding that is bright red and not resembling typical menstrual blood, along with the absence of pain, swelling, or other discharge—there are several potential explanations to consider.

1. Hormonal Imbalance: One of the most common causes of abnormal bleeding is hormonal imbalance. This can occur due to various factors, including stress, significant weight changes, excessive exercise, or underlying medical conditions such as polycystic ovary syndrome (PCOS). Hormonal fluctuations can lead to irregularities in the menstrual cycle, resulting in prolonged or unexpected bleeding.

2. Ovulation Bleeding: Some women experience ovulation bleeding, which can occur around the midpoint of their menstrual cycle. This bleeding is typically light and may be accompanied by other symptoms such as mild cramping. However, if you have not experienced this before, it may not be the likely cause in your case.

3. Uterine Polyps or Fibroids: Non-cancerous growths in the uterus, such as polyps or fibroids, can lead to abnormal bleeding. These growths can cause heavy bleeding, prolonged periods, or bleeding between periods. A transvaginal ultrasound can help identify these conditions.

4. Infections: Certain infections, including sexually transmitted infections (STIs) or pelvic inflammatory disease (PID), can cause abnormal bleeding. While you mentioned the absence of pain or unusual discharge, it is still worth considering this possibility, especially if you have had any recent changes in sexual partners or practices.

5. Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and can lead to irregular bleeding. It is often related to prolonged exposure to estrogen without sufficient progesterone. Women with this condition may experience heavy or prolonged menstrual bleeding.

6. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual cycles and lead to abnormal bleeding. Thyroid function tests can help determine if this is a contributing factor.

7. Medications: Certain medications, particularly hormonal contraceptives or anticoagulants, can lead to changes in bleeding patterns. If you have recently started or changed any medications, this could be a factor.

8. Pregnancy-Related Issues: Although you mentioned that this is not typical menstrual bleeding, it is essential to rule out any pregnancy-related complications, such as a miscarriage or ectopic pregnancy, especially if there is any chance of pregnancy.

Given the duration and nature of your bleeding, it is crucial to consult a healthcare provider, preferably a gynecologist, for a thorough evaluation. They may recommend a pelvic exam, ultrasound, blood tests, or other diagnostic procedures to determine the underlying cause of your symptoms.
In the meantime, it is advisable to keep track of your bleeding patterns, including the amount, color, and any associated symptoms, as this information can be helpful for your healthcare provider in making an accurate diagnosis.
In summary, while there are several potential causes for your prolonged vaginal bleeding, a thorough medical evaluation is essential to identify the specific reason and to determine the appropriate treatment. Do not hesitate to seek medical attention, as early intervention can help address any underlying issues effectively.