II. Causes

  1. Anticoagulants and antiplatelet agents
    1. High dose Aspirin (e.g. 325 mg)
    2. Warfarin
  2. Hormonal agents
    1. Corticosteroids
    2. Oral Contraceptives
      1. Most common cause of mid-cycle bleeding
    3. Estrogen Replacement Therapy or Herbal Estrogen
    4. Tamoxifen
    5. Intrauterine Device (also with local non-hormonal effects)
  3. Herbal supplements
    1. Ginseng
    2. Ginkgo
    3. Soy Protein
  4. Neuropsychiatric agents
    1. Lithium
    2. Tricyclic Antidepressant
    3. Selective Serotonin Reuptake Inhibitors (SSRI)
    4. Sedative-Hypnotic Medications
    5. Antipsychotic Medications
    6. Phenytoin
  5. Miscellaneous
    1. Rifampin
    2. Tobacco abuse

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