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Vaginal Bleeding Between Periods

Overview

Abnormal vaginal bleeding between periods is also called intermenstrual bleeding, spotting, and metrorrhagia. When bleeding occurs between normal periods, there are many possible causes.

While some causes may be easy to treat, others can indicate a serious underlying condition. Whether you notice spotting or heavier bleeding between periods, it’s important to see your doctor for testing, diagnosis, and treatment options. Potential causes of bleeding between periods include:

  • a growth in your uterus or cervix
  • stress
  • a change in medication
  • a miscarriage
  • vaginal dryness
  • a hormone imbalance
  • cancer
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Causes

Causes of vaginal bleeding between periods

Bleeding between periods isn’t a normal part of the menstrual cycle.

The average cycle lasts 21 to 35 days. Normal vaginal bleeding, also known as your period, can happen for a few days to a week. Any bleeding outside of this is considered abnormal and can be caused by a variety of factors. These include:

1. Hormonal imbalance

Estrogen and progesterone are the two hormones that regulate your cycle. You may have spotting if they get out of balance. The following can all affect your hormone balance:

  • dysfunctional ovaries
  • thyroid gland problems
  • starting or stopping birth control pills

As well, some women spot during ovulation as a result of hormonal changes.

When starting any type of hormonal contraceptive, abnormal bleeding is common during the first three months, according to the National Health Services of the United Kingdom. These contraceptives include:

  • birth control pills
  • intrauterine device
  • contraceptive patch
  • contraceptive implant or injection

2. Pregnancy complications

Complications during pregnancy can cause spotting. Both a miscarriage and an ectopic pregnancy can cause bleeding. An ectopic pregnancy occurs when a fertilized egg implants itself in the fallopian tube instead of the uterus.

Spotting during pregnancy may not mean you’re having a miscarriage. However, if you’re pregnant and experience any vaginal bleeding, you should contact your doctor immediately.

3. Uterine fibroids

Uterine fibroids are noncancerous growths that form in the uterus. They aren’t uncommon in women who’ve given birth.

4. Infection

Vaginal bleeding between periods may indicate an infection of your reproductive organs. Infection can cause inflammation and bleeding. Causes include:

  • sexually transmitted infection
  • vaginal douching
  • intercourse
  • pelvic inflammatory disease, which is marked by inflammation of the reproductive organs that leads to scarring

5. Cancer

Less commonly, a cancer of any of these organs can cause bleeding:

6. Rare causes

Other possible causes of vaginal bleeding are rare and include:

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Seek medical help

When to seek medical help

You should consult your doctor any time you have abnormal vaginal bleeding. The cause of the bleeding could be serious and should be determined. See your doctor right away if you’re pregnant and have vaginal bleeding.

If you have other serious symptoms in addition to bleeding, you may need emergency medical attention. These include:

  • pain
  • fatigue
  • dizziness
  • fever
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Diagnosis and treatment

What to expect at a doctor’s appointment

Diagnosis

When you see your doctor about bleeding between periods, be prepared to answer questions about your symptoms.

It’s helpful to 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’ve experienced and any medications you’re taking.

Your doctor will also likely give you a physical exam, including a pelvic exam.

Diagnostic tests can help your doctor find the cause of the bleeding. Your doctor may draw blood to check hormone levels. You may need to have cultures taken or tissue removed from your cervix or the lining of your uterus for testing, which is called a biopsy. Your doctor may also want to perform an ultrasound.

Treatment

There is no specific treatment for vaginal bleeding between periods. Treatment will vary based on what’s causing your abnormal vaginal bleeding.

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Complications

Consequences of ignoring vaginal bleeding between periods

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.

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Prevention

Preventing vaginal bleeding between periods

You may not be able to prevent bleeding between periods depending on the cause. However, in some cases, preventive measures can help.

Maintain a healthy lifestyle and a normal weight because being 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 (Advil) or naproxen (Aleve, Naprosyn), which can actually help reduce bleeding. Avoid taking aspirin (Bufferin), which may increase your risk of bleeding.

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