ABNORMAL VAGINAL BLEEDING 159
Does either of the following apply?
You have only recently started having periods
You are over 40
Neither
ACTION
MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you are concerned. Your menstrual periods may become irregular as you approach menopause.
Have you had sex in the past 3 months?
Had sex
Not had sex
ACTION
MAKE AN APPOINTMENT
TO SEE YOUR DOCTOR Bleeding after menopause may be due to a minor problem affecting the vagina or cervix, such as cervical erosion( in which the cervix becomes covered with delicate tissue, which has a tendency to bleed). However, the possibility of cancer of the uterus needs to be ruled out.
ACTION
MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you are concerned. Irregular periods are fairly common in the first year or so of menstruation.
ACTION
MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you are concerned or if your pattern does not return to normal within three menstrual cycles. Having an occasional irregular period is unlikely to indicate a serious problem if the period was normal in all other respects.
Have you noticed bleeding within a few hours of having sex?
Bleeding after having sex
Bleeding unrelated to having sex
ACTION
MAKE AN APPOINTMENT TO SEE YOUR DOCTOR if you cannot identify a possible cause for your abnormal bleeding from this chart.
! Hormonal contraceptives
In the first few menstrual cycles after starting hormonal contraception or changing to a different type of oral contraception, spotting is fairly common. If abnormal bleeding persists or develops when you have had no previous problems, you should consult your doctor. He or she may examine you and change the dosage or type of hormonal contraceptive.
ACTION
MAKE AN APPOINTMENT TO SEE YOUR DOCTOR You may have a cervical abnormality, such as cervical erosion( which causes fragile tissue that has a tendency to bleed to form on the surface of the cervix), the development of precancerous cells, or cancer of the cervix.
ACTION
CALL YOUR DOCTOR NOW Bleeding, especially if accompanied by pain in the lower abdomen, may be the first sign of an ectopic pregnancy or of an impending miscarriage, even if you were not aware of being pregnant.