Gynecologic hemorrhage represents excessive bleeding of the female reproductive system. Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive. Hemorrhage associated with a  pregnant state  or during delivery is an obstetrical hemorrhage. Types
Metrorrhagia (metro = womb, -rrhagia = excessive flow) is uterine bleeding at irregular intervals, particularly between the expected menstrual periods. Postcoital bleeding is vaginal bleeding after sexual intercourse. Causes
Causes of gynecologic bleeding include:

Hormonal
Anovulation is a common cause of gynecological hemorrhage. Under the influence of estrogen the endometrium (uterine lining) is stimulated and eventually such lining will be shed off (estrogen breakthrough bleeding). The anovulation chapter discusses its multiple possible causes. Longstanding anovulation can also lead to endometrial hyperplasia and facilitate the development of endometrial cancer. Neoplasm
Cancer of the uterus is always a concern, specifically when the bleeding occurs after menopause. Other types of cancer include cervical cancer; bleeding in that case can sometimes be triggered by postcoital bleeding. Cancers of the vagina or fallopian tubes are rare causes of hemorrhage. Uterine fibroids represent a common, benign condition that may lead to bleeding, specifically if the lesion affects the uterine cavity. Polyps of the uterine lining are a common cause of bleeding, but such bleeding tends to be light. Trauma
Sexual assault and rape can lead to injury and gynecological hemorrhage. Accidents to the lower abdomen may lead to internal or external bleeding.
Some trauma specialists suggest increasing inquiry into information about childrens trauma history and exposure to violence, since the majority of people (about 80%) responsible for child maltreatment are the childs own parents. Trauma-specific intervention for children may be useful in preventing future symptoms. Treatment
Treatment of DPDR is often difficult and refractory. Some clinicians speculate that this could be due to a delay in diagnosis by which point symptoms tend to be constant and less responsive to treatment. Additionally, symptoms tend to overlap with other diagnoses. Some results have been promising, but are hard to evaluate with confidence due to the small size of trials. However, recognizing and diagnosing the condition may in itself have therapeutic benefits, considering many patients express their problems as baffling and unique to them, but are in fact: one, recognized and described by psychiatry; and two, those affected by it are not the only individuals to be affected from the condition. However, symptoms are often transient and can remit on their own without treatment.Treatment is primarily non-pharmacological and can include paradoxical intention, record keeping, positive reward, flooding, psychotherapy, cognitive-behavioral therapy, psychoeducation, self-hypnosis, and meditation. Meditation with the focus on the body has been used to achieve self awareness as it allows feelings, which otherwise are put aside or neutralized by the DPD condition. Self-hypnosis training can be helpful and entails training patients to induce dissociative symptoms and respond in an alternative manner.