Abnormal vaginal bleeding between periods is also called breakthrough bleeding, spotting, and metrorrhagia. When bleeding occurs between normal periods, there are many possible causes, and some of them point to something worse.
Although some causes may be easy to treat, others may indicate a serious underlying condition. Whether we notice spotting or heavier bleeding between periods, it’s important to see a doctor for testing, diagnosis, and treatment.
A very light period can sometimes resemble spotting and vice versa. The two factors that can help a person determine if the bleeding is a period or spotting are the duration and the volume.
A period usually lasts around 4 days or more, while spotting only lasts 1-2 days. During a period, there is usually enough blood to soak through a compress. Menstrual blood is also usually red, while bleeding between periods is usually dark red or brown.
Types of bleeding between periods
There are a few different types of bleeding that can occur when we are not in the week of the rule:
- Staining : It is likely that we are staining red or brown on the toilet paper or a drop or two of blood on the underwear. However, the doctor will only consider the bleeding to be “spotting” if it does not occur during the period and does not require us to use a pad or tampon.
- Light bleeding : This type of bleeding occurs just before or after the period. Technically it is not spotted, it is considered part of the rule.
- Intermenstrual bleeding : Intermenstrual bleeding occurs if we are taking oral contraceptives. This type of bleeding between periods is usually caused by low estrogen levels.
- Abnormal bleeding : Any heavy bleeding that requires the use of a tampon or pad that occurs outside of the cycle and is not caused by hormonal birth control pills is abnormal. Also called abnormal uterine bleeding or abnormal vaginal bleeding.
Bleeding between periods is not a normal part of the menstrual cycle. The average cycle lasts from 21 to 35 days. Normal vaginal bleeding, also known as a period, can occur for a few days or a week. Any bleeding outside of this is considered abnormal and can be caused by a variety of factors. Some of them are:
Estrogen and progesterone are the two hormones that regulate the cycle. We may have spots if they get out of balance. Hormonal balance can be affected by dysfunctional ovaries, thyroid gland problems, and starting or stopping birth control pills.
Also, 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. The most common contraceptives are birth control pills, intrauterine device, contraceptive patch and contraceptive injection or implant.
Menopause is the time in a person’s life when they permanently stop having menstrual periods and cannot get pregnant naturally. A person reaches menopause when they have not had a period for at least 12 months.
Perimenopause is the transition to menopause and can last up to 10 years. During perimenopause, hormone levels can fluctuate randomly, which can lead to menstrual symptoms such as irregular spotting and changes in the length and heaviness of a person’s period.
Complications during pregnancy can cause bleeding between periods. Both a miscarriage and an ectopic pregnancy can cause spotting. An ectopic pregnancy occurs when a fertilized egg implants in the fallopian tube instead of the uterus.
Spotting during pregnancy may not mean we are having a miscarriage. However, if we are pregnant and experience vaginal bleeding, we should contact a doctor immediately.
Vaginal bleeding between periods can indicate an infection of the reproductive organs. The infection can cause swelling and bleeding.
Some of the causes can be sexually transmitted infection, douching, intercourse, or pelvic inflammatory disease, which is characterized by inflammation of the reproductive organs leading to scarring.
Other possible causes of vaginal bleeding between periods are rare and include:
- Insertion of an object into the vagina
- extreme stress
- Thyroid disorders
- Significant weight gain or loss
Can it be prevented?
You may not be able to prevent bleeding between periods depending on the cause. However, in some cases, preventive measures can help. Maintaining a healthy lifestyle and normal weight is recommended because being overweight can lead to abnormal periods.
If we take birth control pills, we will do so as directed to avoid a hormonal imbalance. We will do moderate exercise to maintain health and reduce stress. To control the pain, we’ll use ibuprofen or naproxen, which can actually help reduce bleeding. We will avoid taking aspirin, which can increase the risk of bleeding.
In some cases, this type of abnormal bleeding will resolve on its own. However, for some women, the underlying cause requires treatment. Ignoring the problem and not seeing 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 can be life-threatening.
When to go to the doctor?
We should see a doctor every time we have abnormal vaginal bleeding. The cause of the bleeding could be serious and needs to be determined. We will see a doctor right away if we are pregnant and have vaginal bleeding.
If we have other serious symptoms in addition to bleeding, we may need emergency medical attention. Some of those signs include pain, fatigue, dizziness, or fever.
Keeping track of your menstrual cycle is recommended. We will note when periods begin and end, the heaviness and duration of the flow, and when and how much we bleed between periods. The doctor will want to know about any other symptoms we have experienced and any medications we are taking.
The doctor will also likely do a physical exam, including a pelvic exam . Diagnostic tests can help find the cause of the bleeding. The doctor may draw blood to check hormone levels. We may need to have cultures taken or tissue removed from the cervix or the lining of the uterus for testing, which is called a biopsy. The doctor may also want to do an ultrasound.