Dark Red Rectal and Vaginal Bleeding: Causes and Concerns - Surgery

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Rectal and vaginal bleeding?


After using the restroom, I noticed blood on the toilet paper (not bright red, but dark red) coming from both the anus and the vagina.
The amount is not significant.
This happened a while ago but stopped, and now it has started again.
It's not menstrual bleeding.
What could be the cause of this?

Yin, 20~29 year old female. Ask Date: 2012/10/09

Dr. Xu Kaixi reply Surgery


Dear Dr.
Hsu Kai-Hsi of the Department of Surgery at Tainan Hospital, Ministry of Health and Welfare: Based on your description, possible sources of bleeding include the gastrointestinal tract and the urogenital system.
It is recommended that you visit the surgical outpatient clinic for further examination and diagnosis.
Wishing you good health and safety from the Department of Surgery at Tainan Hospital, Ministry of Health and Welfare.

Reply Date: 2012/10/09

More Info


When experiencing dark red bleeding from both the rectal and vaginal areas, it is essential to consider a variety of potential causes. The presence of dark red blood can indicate older blood, which may have taken longer to exit the body, and this can be associated with several conditions.

1. Menstrual Cycle Irregularities: If you are a woman of reproductive age, it is possible that what you are experiencing is related to your menstrual cycle. Irregular bleeding can occur due to hormonal imbalances, stress, or changes in your body. If your menstrual cycle has recently changed or if you have experienced any stressors, this could be a contributing factor.

2. Infections: Infections in the vaginal area, such as bacterial vaginosis or sexually transmitted infections (STIs), can lead to abnormal bleeding. These infections may also present with other symptoms like unusual discharge, itching, or a foul odor. If you suspect an infection, it is crucial to seek medical attention for appropriate testing and treatment.

3. Polyps or Fibroids: Uterine polyps or fibroids can cause irregular bleeding. These growths are usually benign but can lead to discomfort and abnormal bleeding patterns. A gynecological examination, including an ultrasound, can help identify these conditions.

4. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside of it, leading to pain and irregular bleeding. If you have a history of painful periods or other symptoms associated with endometriosis, this could be a possibility.

5. Rectal Issues: Dark red bleeding from the rectum could be due to hemorrhoids, anal fissures, or other gastrointestinal issues. Hemorrhoids are swollen veins in the rectal area that can bleed, especially during bowel movements. Anal fissures are small tears in the lining of the anus that can also cause bleeding. If you notice blood on the toilet paper or in the stool, it is essential to consider these possibilities.

6. Pregnancy-Related Issues: If there is any chance of pregnancy, it is essential to consider the possibility of implantation bleeding or complications such as a miscarriage or ectopic pregnancy. If you suspect you might be pregnant, a pregnancy test and consultation with a healthcare provider are recommended.

7. Other Medical Conditions: Conditions such as pelvic inflammatory disease (PID), certain cancers, or bleeding disorders can also lead to abnormal bleeding. If you have other symptoms, such as severe pain, fever, or significant changes in your health, it is crucial to seek medical attention promptly.

Given that you have experienced this bleeding for several days and it is not related to your menstrual cycle, it is advisable to consult a healthcare professional. They can perform a thorough examination, possibly including imaging studies or laboratory tests, to determine the underlying cause of your symptoms.
In the meantime, keep track of any additional symptoms you may experience, such as pain, changes in bowel habits, or any other unusual signs. This information can be helpful for your healthcare provider in diagnosing the issue. Remember, while some causes of dark red bleeding may be benign, others may require prompt medical intervention, so it is always best to err on the side of caution.

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