What Does Bloody Vaginal Discharge Mean? Causes & What to Do

Key takeaways:

• Seeing bloody vaginal discharge right before, during, or after your menstrual period can be normal.
• Blood in vaginal discharge outside of your period is usually a sign of infection or inflammation.
• Hormonal imbalances, vaginal infections, and menopause are a few factors that can lead to bloody vaginal discharge.

There is only one time when bloody vaginal discharge is considered normal, and that is with your regular monthly period. Bleeding at any other time might be a sign of inflammation or infection, both of which require medical treatment. The cause of bloody discharge may not be dangerous, but it may indicate a serious problem that warrants a visit to your doctor.

Is it normal to have bloody vaginal discharge?

Outside of your period, a bloody vaginal discharge is never considered normal. This is true even when the discharge is very light or pink. Bloody discharge can be a sign of bleeding caused by inflammation in the cervix or vagina. This usually occurs due to a vaginal infection.

Blood in your vaginal discharge can also point to something abnormal about your menstrual cycle. During pregnancy, any vaginal bleeding may be a warning signal of placental problems, threatened miscarriage, an ectopic pregnancy, or a risk of preterm labor and premature delivery.

What is bloody vaginal discharge?

By definition, a bloody vaginal discharge is any moisture or secretions of the vagina mixed with blood. Many things can cause blood to mix with such secretions, including inflammation, infections, hormone imbalance, or pregnancy complications.

Common causes of bloody vaginal discharge

Outside of normal periods and pregnancy, causes of a bloody vaginal discharge include the following:

Irregular cycles

The menstrual cycle is an orderly sequence of hormonal changes that alters the lining of your uterus (womb) in preparation for pregnancy. If that doesn’t happen regularly, it can cause that lining to fall away prior to the cycle repeating.

Uterine fibroids

Uterine fibroids are growths of uterine fibrous tissues in the wall of your uterus. They can bleed and exit through your cervix into the vagina.

Uterine or cervical polyps

Polyps can grow out of your cervix or uterus, and either of these types can be benign or malignant. However, during your childbearing years, they are usually benign and can bleed, causing blood in your vagina. The older you are, e.g., into your perimenopausal and menopausal years, they increase the risk of cancer.

Cervicitis

Although inflammation of your cervix, known as cervicitis, is usually due to an infection, it can also occur with a change of acidity in your vagina or because of hormonal changes.

Vaginitis

Unlike cervicitis, which can occur with hormonal changes, inflammation of the vagina, or vaginitis, is usually due to infection. Such infections cause reactive changes in the vaginal cells that can result in microscopic bleeding and blood in a vaginal discharge. Trauma due to sex or foreign bodies can also cause vaginitis.

Infections of concern include the following:

• Yeast
• Bacterial vaginosis (BV)
• Bacterial infections, such as Escherichia coli (E. coli) or sexually transmitted infections (STIs), such as trichomoniasis, gonorrhea, or chlamydia

Menopausal vaginitis

Vaginitis can also occur in menopause due to a lack of estrogen to nurture the vaginal tissues. The resulting loss of vaginal wall thickness causes sloughed cells to collect in the vagina as a watery discharge. When this discharge mixes with the microscopic bleeding from menopausal vaginitis (atrophic vaginitis), it can cause a bloody vaginal discharge.

Abnormalities outside of your uterus

Your menstrual cycle involves an interaction among the following:

• Your uterus, which responds to hormones (estrogen and progesterone) by building up tissue in preparation for pregnancy and, when that doesn’t happen, sheds that tissue.
• Your ovaries, which manufacture estrogen and progesterone, mature eggs, and then release them during ovulation.
• Your hypothalamic-pituitary-ovarian axis, which is the collection of hormonal connections among your pituitary gland, hypothalamus, and ovaries.

Any problems in the cooperation of these can cause irregular cycles and present as bleeding or abnormal menstruation (heavy, absent, irregularly timed periods, or bleeding in between periods).

What bloody vaginal discharge can mean based on your menstrual cycle

Any bleeding inconsistent with your repeating, predictable monthly periods can cause blood to be part of a vaginal discharge. You may experience some spotting (light, periodic bleeding) right before and after your period. Beyond this, though, bloody vaginal discharge outside your period is likely a sign of inflammation or infection.

What bloody vaginal discharge may mean based on appearance, texture, or another symptom or condition

The normal vaginal lubrication and moisture provided by vaginal and cervical glands is called “leukorrhea.”

But this can change in appearance, texture, or other aspects due to abnormalities of your uterus or from infection:

• Heavy bloody vaginal discharge: This can be due to a hormone imbalance, pituitary or hypothalamic problems, ovarian problems in making estrogen or progesterone, or bleeding from fibroids or polyps.
• Light bloody vaginal discharge: Bloody discoloration due to an infection.
• Bloody vaginal discharge accompanied by itching: Usually from the vaginitis caused by a yeast infection.
• Bloody vaginal discharge after sexual intercourse: Bleeding from cervicitis, in which the mechanical act of intercourse traumatizes the inflamed cervical cells (usually due to infection).
• Bloody vaginal discharge during pregnancy: In early pregnancy, it can indicate implantation bleeding, a threatened miscarriage, or an ectopic pregnancy. In later trimesters, it can indicate placental problems or the risk of preterm labor or premature delivery.

Read our guides on vaginal discharge colors and odors for more.

When you should see a doctor about bloody vaginal discharge

When a bloody vaginal discharge occurs outside of what you would expect with your monthly period, it’s likely a sign that something is off. In pregnancy, it may be a sign of a threat to both you and your unborn baby. This means you should always see a doctor if you have a bloody vaginal discharge outside of your normal monthly period.

You should see a doctor if:

• You have bloody discharge outside of your normal menstrual period.
• You have bloody discharge along with other symptoms, like burning, itching, or pain.
• You have bloody discharge and are pregnant or believe you could be.
• You experience signs of any unusual endocrine problems, such as breast discharge.

You should go to the emergency room if there is a bloody vaginal discharge and you:

• You have bloody discharge alongside a high fever, back pain, pelvic pain, or abdominal pain.
• Your discharge comes with painful urination or bowel movements.
• You experience other unexplainable symptoms, like nausea, vomiting, or abdominal distension.

Questions to ask your doctor about bloody vaginal discharge

• Is my bloody discharge a sign of a hormone imbalance or an infection?
• How will you confirm your diagnosis or confirm successful treatment if it’s an infection?
• Should my partner be part of my evaluation?
• What if I’m pregnant or might be pregnant?

How to get rid of or treat bloody vaginal discharge

Treating bloody vaginal discharge will depend on its underlying cause. Below are some common treatment options for bloody vaginal discharge.

Hormone surveillance or treatment

If a bloody discharge is due to hormone problems, blood work is necessary to identify which, among the causes (ovarian, pituitary, or hypothalamic) needs to be addressed. Such blood work will require a pregnancy test and other hormonal studies.

Optional hormone treatment can entail birth control pills before menopause. At or after menopause, hormone replacement under certain conditions can be used after ruling out a malignancy.

Imaging and/or invasive evaluation; possible surgery

If your hormones are normal, an ultrasound with or without a procedure to look for polyps or fibroids should be performed. If indicated, surgery to remove them may be necessary. If you’re menopausal, then invasive evaluation to rule out malignancy (vulvar, vaginal, cervical, or uterine cancer) is mandatory.

Antibiotics or antifungals

Antibiotics are indicated for a bloody vaginal discharge due to Trichomonas, BV, or other bacterial infections; an antifungal is indicated if the cause is a yeast infection.

Frequently asked questions: bloody vaginal discharge

The following are some frequently asked questions you may find helpful.

Is bloody vaginal discharge unhealthy?

Unless it is associated with the beginning or end of your period, bloody vaginal discharge may be cause for concern. Even if it does occur during a normal period, if it’s associated with burning, itching, pain, or an odor, it is not normal and should be addressed properly.

Is it normal to have a bloody discharge for weeks or months?

No. This implies that it is occurring between periods, so it needs to be evaluated properly.

Is bloody vaginal discharge a sign of pregnancy?

It can be if it happens within the first 10 days of conception, as implantation bleeding. But beware that it can also be a symptom of a threatened miscarriage or an ectopic pregnancy.

Final thoughts on blood in vaginal discharge

Your period is a natural turnover of tissue being repeatedly prepared for pregnancy. Any bloody discharge outside of your normal periods indicates infection, abnormal anatomy, or hormone problems–all of which need to be evaluated properly by a medical provider. In pregnancy, it can be a warning signal of pregnancy jeopardy; when menopausal, it can be a warning sign of cancer.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Poushali Bhattacharjee, MD.

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