Abnormal Vaginal Bleeding and Pelvic Inflammation Disease


Unexpected bleeding is always a concern for a woman at any stage of life. Bleeding other than a normal menstrual period can be great cause for alarm. Intermenstrual bleeding refers to vaginal bleeding (other than postcoital) at any time during the menstrual cycle other than during normal menstruation. Postcoital bleeding is non-menstrual bleeding that occurs immediately after sexual intercourse.

Causes of abnormal vaginal bleeding

There are many possible causes for abnormal vaginal bleeding. By itself, it does not necessarily indicate a serious condition.

Possibility of pregnancy

Ovulation might lead to mid-cycle bleeding

Polycystic ovary syndrome is a hormone imbalance that interferes with normal ovulation which can cause abnormal bleeding.

Birth control pills sometimes cause abnormal vaginal bleeding. Minor bleeding between periods during the first few months might occur if you have recently started using birth control pills. Bleeding might occur if not taking your pills regularly

An intrauterine device (IUD)

Infection of the pelvic organs (vagina, cervix, uterus, fallopian tubes, or ovaries) may cause vaginal bleeding

Tests to be done

Doctor should carefully examine medical history. A complete physical examination will be performed including a thorough pelvic exam

The exam includes careful inspection of the external genitalia, urethra, and anal area.

The vaginal walls and cervix are inspected for the presence of any abnormalities or retained foreign objects. Fluid samples may be taken to test for the sexually transmitted diseases

Pap smear will be taken to examine for cancer

An ultrasound of the abdomen and pelvis may be performed

An endometrial biopsy may be performed to take a sample of tissue from the lining of the uterus

Pelvic Inflammation Disease

Most cases of PID are due to the bacteria that cause chlamydia and gonorrhea. These are sexually transmitted infections (STIs).

You might be at risk if you

Are sexually active and younger than 25

Have more than one sex partner


Symptoms of PID:

Fever (not always present)

Pain in the pelvis, lower abdomen, or sometimes the lower back

Vaginal discharge with abnormal color, texture, or smell

Other symptoms that may occur with PID:

Bleeding after intercourse



Frequent or painful urination

Increased menstrual cramping

Irregular menstrual bleeding or spotting

Lack of appetite

Nausea, with or without vomiting

No menstruation

Painful sexual intercourse

If left untreated, it can cause serious problems, such as infertility.

Diagonosis of PID:

Doctor will do a pelvic exam and will check for:

Abnormal discharge from your vagina or cervix

Lumps near your ovaries and tubes

Pain in your pelvic organs

Your doctor will also test you for STIs and urinary tract infection, and if needed, pregnancy. your doctor may do other tests.

Ultrasound – a test that uses sound waves to take pictures of the pelvic area.

Endometrial biopsy – the doctor removes and tests a small piece of the endometrium (the inside lining of the womb)

Laparoscopy – the doctor inserts a small, lighted tube through your abdomen (stomach area) to look at your pelvic organs.

Treatment of PID:

Antibiotics will be prescribed

Hospitalization required if it is severe

Prevention of PID:

Practice safer sex (use of condom)

Don’t douche ( it increases the risk of PID)

Get tested regularly for sexually transmitted disease

See a doc right away if you are seeing some of the above-mentioned symptoms