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 warn of 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 look like 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 pad. 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 you're not on your period week:
- Manchado (coffee with a splash of milk): It is likely that we are staining red or brown on toilet paper or a drop or two of blood on underwear. However, your doctor will only consider the bleeding "spotting" if it doesn't occur during your period and doesn't require you to wear a pad or tampon.
- Light bleeding: This type of bleeding occurs just before or after the period. It's not technically spotted, it's considered part of the rule.
- breakthrough bleeding: Breakthrough 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.
Causes
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:
Hormonal imbalance
Estrogen and progesterone are the two hormones that regulate the cycle. We may have spots if they get unbalanced. Hormone 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, the intrauterine device, the contraceptive patch, and the contraceptive injection or implant.
perimenopausal spotting
Menopause is the time in a person's life when she permanently stops having menstrual periods and cannot get pregnant naturally. A person reaches menopause when she has 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 of pregnancy
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.
Infection
Vaginal bleeding between periods can indicate an infection of the reproductive organs. The infection can cause inflammation 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 that leads to scarring.
Rare causes
Other possible causes of vaginal bleeding between periods are rare and include:
- Cancer
- Insertion of an object into the vagina
- Extreme stress
- Diabetes
- 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. It is recommended to maintain a healthy lifestyle and a normal weight because being overweight can cause 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 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 consult a doctor every time we have abnormal vaginal bleeding. The cause of the bleeding could be serious and must be determined. We will consult a doctor immediately if we are pregnant and have vaginal bleeding.
If we have other severe symptoms in addition to bleeding, we may need emergency medical attention. Some of those signs include pain, fatigue, dizziness, or fever.
Recommended keep track of menstrual cycle. We'll take note of when periods start and end, how heavy and long the flow is, 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 lining of the uterus for testing, called a biopsy. The doctor may also want to perform an ultrasound.