Abnormal Vaginal Bleeding

Abnormal vaginal bleeding can frequently be evaluated and diagnosed with a thorough history and physical examination with minimal testing. Most ovulatory menstrual cycles are regular, cyclic and predictable. The typical interval is between 25-34 days apart and lasting 3-7 days in duration with an average blood loss of 30-80 cc. When there is a deviation of this pattern, there may be an abnormality that should be investigated.

Common terminology to explain these abnormal variations are:

• menorrhagia (cyclic menstrual bleeding that is excessive in duration and/or amount)
• ligomenorrhea (bleeding or light spotting that occurs at intervals longer than 35 days)
• metrorrhagia (bleeding that occurs at irregular intervals)
• menometrorrhagia (excessive and prolonged bleeding at frequent and irregular intervals)