Besides a possible miscarriage, wise up to what other “culprits” may cause you to bleed “down there”.


It can be worrying when you experience abnormal vaginal bleeding when it’s not your period. Although spotting during pregnancy when you’re not supposed to may cause you to feel unsettled, your fears may be unfounded.

Notes Dr Dharshini Gopalakrishnakone, an ob-gyn at Kierauniv International Clinic for Women, “[Spotting] is fairly common in women who have not reached menopause yet and usually is of a benign treatable nature.”

Ob-gyn Dr Peter Chew adds that spotting is a symptom of an underlying issue, so treating the causes will stop the bleeding. Both Dr Dharshini and Dr Chew share some of the most common causes of abnormal bleeding…

1) Possible miscarriage

WHAT? Typically, any form of bleeding within the first trimester of pregnancy is a sign of miscarriage. Dr Chew states that spontaneous miscarriages occur in about 20 per cent of women in their first trimester of pregnancy.

EXPERTS SAY Unfortunately, there is little you can do to save a pregnancy that’s going south. This is because 80 per cent of miscarriages are the result of genetic factors, Dr Chew explains. However, not all early pregnancy bleeding is bad news as most pregnancies continue to term ― with or without treatment. He says, “If the bleeding stops and the foetal growth is not compromised ― as measured from ultrasound examinations ― the baby has the best chance of survival”. Dr Dharshini adds, “Once a foetus has reached 12 weeks, there is a huge chance that they are going to be just fine.” She notes that bleeding after 12 weeks is unusual and may signify severe health issues, like a low-lying placenta.

“If the bleeding stops and the foetal growth is not compromised…the baby has the best chance of survival.”

2) Hormonal imbalance

WHAT? Irregular bleeding can be the result of a progesterone deficiency, or an imbalance of progesterone and oestrogen levels.

EXPERTS SAY Various organ functions affect the level of progesterone and oestrogen in your body. These include the brain, the pituitary glands, thyroid and adrenal glands, notes Dr Chew. In addition, a range of chronic medical conditions such as diabetes, renal diseases and autoimmune diseases and drugs can affect your hormone levels. So, it’s best to check with your doc to find out why you’re bleeding.

If you’re not pregnant, you may bleed as a result of…

3) Contraceptive use

WHAT? Contraceptives loaded with artificial hormones may interfere with your body’s natural hormonal balance and cause irregular bleeding.

EXPERTS SAY Once you’re off the pill and it’s no longer in your body, these are, therefore, unlikely to affect your body’s hormonal levels in the long term. However, Dr Chew, notes that for some women, the imbalance can last for more than three months after you stop taking the pills, causing irregular menstrual patterns and bleeding. Speak to your medical practitioner to resolve this issue.

4) Intrauterine growths

WHAT? Fibroids, cysts and polyps are just some types of uterine growths that can give rise to heavy and abnormal bleeding.

EXPERTS SAY Pay attention to your bleeding patterns. Dr Chew notes, a fibroid in the uterus will cause heavy and irregular bleeding, while multiple fibroids can cause heavy but regular bleeding. You are spotting because of the hormonal imbalance caused by these fibroids. Cysts, on the other hand, can trigger pelvic congestion (a chronic and painful medical condition in women caused by varicose veins in the lower abdomen) which causes bleeding. Medical treatment is required to remove or to help shrink these growths, so be sure to check with your doc.

What to do when you bleed?

If you are bleeding heavily or are spotting for the first time, see your ob-gyn as soon as possible. Dr Chew advises that you get a medical checkup if you encounter the following serious situations:

* Recurrent bleeding.

* Post-coital bleeding (bleeding after sex).

* Heavy and irregular bleeding.

Photo: iStock

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