Hormonal Imbalance: This is often the most common cause of chronic vaginal bleeding, particularly in women of reproductive age. Hormonal fluctuations can lead to irregular ovulation, thickening of the uterine lining, and subsequent bleeding.

Uterine Fibroids: These are common benign tumors that can cause prolonged vaginal bleeding due to their location and effect on the uterine lining.
Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, leading to irregular and prolonged bleeding.
Cervical Polyps: Growths on the cervix that can cause irregular bleeding, especially after sexual intercourse or douching.
Vaginal Infections: Certain infections, such as pelvic inflammatory disease (PID), can cause chronic bleeding.

Endometrial Cancer: Although less common, it is crucial to rule out cancer as a cause of chronic vaginal bleeding, especially in postmenopausal women or those with risk factors.
Cervical Cancer: Another critical diagnosis not to miss, as it can also present with abnormal vaginal bleeding.
Pregnancy-Related Complications: Ectopic pregnancy or a molar pregnancy can cause chronic bleeding and are medical emergencies.
Bleeding Disorders: Conditions like von Willebrand disease can lead to heavy or prolonged menstrual bleeding.

Uterine Sarcoma: A rare type of cancer that originates in the muscle and supporting tissues of the uterine walls.
Vaginal Cancer: A rare type of cancer that can cause abnormal vaginal bleeding.
Ovarian Cancer: Although more commonly associated with pelvic pain and bloating, ovarian cancer can also cause irregular vaginal bleeding.
Genetic Disorders: Certain genetic conditions can affect hormone regulation and lead to chronic vaginal bleeding, such as polycystic ovary syndrome (PCOS).