Bleeding or spotting between regular periods can alert you. When this happens, you may only see a spot or two of blood on your underwear or toilet paper, or you may be bleeding like you have your period. While there are harmless reasons for this, it can also indicate more serious problems that require treatment.
What is and what is not
People generally refer to any bleeding outside of the menstrual cycle as spotting. However, spotting, breakthrough bleeding, and other problems vary in timing and amount of bleeding.
- Stains: It could just be a reddish tint from toilet paper or a couple of drops on your underwear. It is considered bleeding medically if it is not during your period and generally does not require the use of a tampon or tampon.
- Light bleeding: This type of bleeding occurs just before or after your period and is technically not bleeding; it is considered part of your period.
- Breakthrough bleeding – Mid-cycle bleeding is heavier than spotting.
Bleeding other than your period severe enough to require feminine products is called breakthrough bleeding.
- Breakthrough bleeding is defined as bleeding in the middle of a cycle if you are taking oral contraceptives and is generally caused by estrogen levels too low to suppress your natural menstrual cycle.
- If heavy off-cycle bleeding is not associated with oral contraceptive pills, it is defined as abnormal uterine bleeding or abnormal vaginal bleeding.
Normal menstrual bleeding
Most women will recognize their own cycles after a few years of menstruation. While it may seem like you are losing a lot of blood, it is usually two to eight tablespoons of blood.
About 14 days after the start of menstruation, ovulation occurs and the ovary releases the egg.
- Some people notice spotting during ovulation, which may be normal, but you should discuss this with your healthcare provider.
- If there are no fertilized egg implants, the lining of the uterus is lost during menstrual bleeding about two weeks after ovulation.
Causes of bleeding
While the causes of irregular bleeding can vary based on a person's health, pregnancy, birth control, and infections are some of the most common causes.
There are several possible reasons associated with pregnancy:
- Implant bleeding : spotting can occur at a time when fertilized eggs in the uterus begin to grow.
- Miscarriage : You may or may not know that you are pregnant, and bleeding could be a sign that the pregnancy has ended.
- Ectopic pregnancy : This occurs when a fertilized egg implants itself outside the uterus.
- Abortion – Bleeding can occur after a pregnancy is terminated with medications or a procedure.
You may see bleeding associated with your birth control method:
- Oral Contraceptives : Starting, stopping, or not taking oral contraceptives (birth control pills) can cause bleeding or bleeding.
- Other hormonal contraceptive methods : Irregular vaginal bleeding can occur when a contraceptive patch, implant or injection is used.
- Intrauterine Devices (IUDs) : IUDs are known to occasionally cause spotting.
Bleeding can occur in conditions that affect your hormones:
There are several infectious diseases that can cause bleeding:
Bleeding during menstruation
Light bleeding just before or after your period is not considered spotting, but is just normal during your period.
Several possible causes include:
- Endometriosis (abnormal growth of uterine tissue outside the uterus)
- Vaginal foreign object trauma or sexual trauma
- Uterine fibroids (benign growths in the uterus)
- Malignant tumors including cervical cancer, uterine cancer, uterine sarcoma, ovarian cancer, and vaginal cancer.
- Certain medications, especially blood thinners and tamoxifen.
- Some gynecological procedures.
- Urethral prolapse or polyps
When to contact a healthcare provider
Use a menstrual cycle calendar to record the number of tampons or pads you use. This information can help your healthcare provider determine if you are bleeding heavily.
Any unexplained vaginal bleeding between periods is a reason to call your doctor. While it should be communicated at any age, it is especially important for people who have not yet gone through puberty and for women who have gone through menopause.
If you are pregnant and have spotting or bleeding, you should see your doctor.
You should seek immediate medical attention if bleeding is heavy or accompanied by pain, fever, dizziness, chills, nausea, or vomiting.
You should expect to provide a complete medical history when visiting your doctor for a diagnosis of bleeding or spotting between periods. If you have entered a menstrual calendar, this will help you.
Your ISP may ask:
- How long have you had bleeding between periods?
- Does this happen every month or for the first time?
- At what point in the menstrual cycle did the bleeding start and how long did it last?
- Do you experience menstrual cramps when you bleed between periods?
- Is there anything that makes the bleeding worse or easier?
- Does bleeding increase with increased physical activity?
If you are pregnant or have recently had a miscarriage or abortion, it is important to tell your healthcare provider. The same applies if you have experienced any trauma or have undergone intrauterine medical or surgical procedures.
If this is your first time seeing your doctor, you will want to know how old you were, when your period started, if you are sexually active, and what method of birth control you can use.
Remember to inform your doctor of any prescription or over-the-counter medications (including herbal supplements) that you are taking.
You may have a pelvic exam, including a Pap test, if you haven't had one recently. Additional tests, such as blood tests or imaging tests, may also be needed.
Treatment for vaginal or uterine bleeding will depend on your diagnosis.
Frequently asked questions
What is the most common cause of bleeding between periods?
The most common cause of bleeding between periods is hormonal. and it can include the use of hormonal contraceptives or menopause.
Who is most likely to experience breakthrough bleeding while taking hormonal birth control?
Women who smoke or skip birth control pills are more likely to experience breakthrough bleeding than non-smokers or those who adhere to a prescription hormonal contraceptive schedule.
Should I be concerned if bleeding between periods is accompanied by other symptoms?
If you experience fever, dizziness, bruising, or pain during bleeding between periods, you should see your doctor.
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You are right to fear abnormal vaginal bleeding and should discuss this with your healthcare provider. While this may have only a minor cause, it can also be a sign of a condition that needs attention, including pregnancy or miscarriage.