Vaginal bleeding between periods is also called intermenstrual bleeding, spotting, and metrorrhagia. When bleeding occurs between normal periods, there are many possible causes. Because spotting can indicate a serious underlying condition, you should see your doctor for testing, diagnosis, and treatment options. Potential causes include growths in the uterus or cervix, a miscarriage, vaginal dryness, a hormone imbalance, and cancer.
Bleeding between periods is not a normal part of the menstrual cycle. On average, the cycle is 28 days long with a four-day period of bleeding. A cycle between 21 and 35 days long and a period that lasts between two and seven days is normal . Any bleeding outside of this is considered abnormal and can be caused by a variety of factors:
- Hormonal imbalance: Estrogen and progesterone are the two hormones that regulate your cycle. If they get out of balance, you may have spotting. Dysfunctional ovaries, thyroid gland problems, and starting and stopping birth control pills, can all affect your hormone balance.
- Intrauterine device : This type of birth control is a plastic device inserted into the uterus. It can cause abnormal bleeding.
- Pregnancy complications: Complications during pregnancy can cause spotting. Both miscarriages and ectopic pregnancies — which is when the fertilized egg implants itself in the fallopian tube instead of the uterus— can cause bleeding.
- Uterine fibroids or polyps : These are non cancerous growths that form in the uterus. They are not uncommon in women who have had children.
- Infection : Vaginal bleeding between periods may indicate an infection of the reproductive organs. Infection can cause inflammation and bleeding and may be from a sexually transmitted infection, may occur after douching or after intercourse, or may be due to pelvic inflammatory disease (marked by inflammation of the reproductive organs leading to scarring).
- Cancer : Less commonly, cancer of the cervix, vagina, uterus, or ovaries may cause bleeding.
- Rare causes: Other possible causes of vaginal bleeding are rare : having an object in the vagina, extreme stress, and diabetes.
Any time you have abnormal vaginal bleeding, you should contact your doctor. The cause of the bleeding could be serious and should be determined. I f you are pregnant and have vaginal bleeding, see your doctor right away.
If you experience other serious symptoms with the bleeding, you may need emergency medical attention. These serious symptoms include:
When you see your doctor about bleeding between periods, be prepared to answer questions about your symptoms. It is helpful if you keep a record of your cycle. Take note of when your periods begin and end, the heaviness and duration of your flow, and when and how much you bleed between periods. Your doctor will want to know about any other symptoms that you have experienced and any medications you are taking.
Your doctor will also likely give you a physical exam, including a pelvic examination.
Diagnostic tests can help your doctor pin point the cause of the bleeding. Your doctor may draw blood to check hormone levels. You may need to have cultures taken or tissue removed (biopsy) from your cervix or the lining of the uterus for testing. Your doctor may also want to perform an ultrasound — an imaging technique that uses sound waves to create a picture of your reproductive organs.
In some cases, this kind of abnormal bleeding will resolve on its own. However, for some women, the underlying cause requires treatment. Ignoring the problem and failing to see a doctor can lead to a worsening of the problem. If the cause of the bleeding is an infection, cancer, or another serious disorder, the consequences could be life threatening.
Depending on the cause of your abnormal bleeding, you may not be able to prevent it . In some cases, though, preventative measures can help. Maintain a healthy lifestyle and a normal weight because b eing overweight can lead to abnormal periods. If you take birth control pills, do so as directed to avoid a hormonal imbalance. Exercise moderately to maintain health and reduce stress. To manage pain, use ibuprofen or naproxen; t hese pain killers can actually reduce bleeding. Avoid aspirin, which may increase bleeding.