gynecology and obstetrics
Vaginal Bleeding
Key Points
Pregnancy must be excluded in women of reproductive age even when history does not suggest it. Ovulatory dysfunction is the most common cause of abnormal uterine bleeding during the reproductive years. Vaginitis, foreign bodies, and trauma are common causes of vaginal bleeding before menarche; sexual abuse is a less common cause but, if suspected, requires prompt evaluation. Postmenopausal vaginal bleeding needs further evaluation to exclude cancer. 