[1] Generally, it is either part of a normal menstrual cycle or is caused by hormonal or other problems of the reproductive system, such as abnormal uterine bleeding.

The treatment of vaginal bleeding is dependent on the specific cause, which can often be determined through a thorough history, physical, and medical testing.

[9] The parameters for normal menstruation have been defined as a result of an international process designed to simplify terminologies and definitions for abnormalities of menstrual bleeding.

[4] Bleeding in children is of concern if it occurs before the expected time of menarche and in the absence of appropriate pubertal development.

[12] Vaginal bleeding in the first week of life after birth is a common observation, and pediatricians typically discuss this with new mothers at the time of hospital discharge.

[7] While vaginal bleeding in children is typically alarming to parents, most causes are benign, although sexual abuse or tumor are particularly important to exclude.

Lastly, a normal and common side effect of birth control includes vaginal spotting or bleeding.

[2] A more specific clinical guideline, called the PALM-COEIN system, has been developed by FIGO (International Federation of Gynecology and Obstetrics) to classify the causes of abnormal uterine bleeding.

[35] Uterine fibroids are benign tumors made of muscle cells and other tissues located in and around the wall of the uterus.

In 2011, the International Federation of Gynaecology and Obstetrics (FIGO) recognized two systems designed to aid research, education, and clinical care of women with abnormal uterine bleeding (AUB) in the reproductive years.

[9]In postmenopausal vaginal bleeding, the primary goal of any diagnostic evaluations is to exclude endometrial hyperplasia and malignancy.

Guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend transvaginal ultrasonography as an appropriate first-line procedure to identify which patients are at higher risk of endometrial cancer.

[40]Severe acute bleeding, such as caused by ectopic pregnancy and post-partum hemorrhage, leads to hypovolemia (the depletion of blood from the circulation), progressing to shock.

[22] A possible complication from protracted vaginal blood loss is iron deficiency anemia, which can develop insidiously.

These hormonal medications include birth control pills, medroxyprogesterone acetate (brand name Depo-Provera), and conjugated equine estrogen.

[2] Surgical treatments may also be considered if the bleeding is severe or if there are reasons patients cannot take the hormonal medications listed above.

Hysterectomy will result in infertility, so surgical decisions will include women's preferences regarding future fertility when possible.