Causes of abnormal vaginal bleeding in a Family Practice Center

Abnormal vaginal bleeding had an incidence of 20.0 per 1,000 woman-years in patients of the Kanawha Valley Family Practice Center. Contraception-related bleeding was the most common cause, accounting for 28 percent of the cases. Anovulatory and dysfunctional uterine bleeding were the next most common causes, accounting for 15 percent and 13 percent, respectively. All three causes were uncommon in women aged 41 to 55 years, and absent in women older than 55 years. Perimenopausal bleeding, the dominant cause of abnormal vaginal bleeding in the 41-to-55-year group, was also absent in women older than 55 years of age. In women 56 years of age or older, endometrial carcinoma caused 28.6 percent of the bleeding; it did not occur in any other group.