Bleeding Between Periods

Bleeding during periods (menstruation) is fundamental to the reproductive cycle of the female anatomy. However, there are times when a girl or woman may bleed in between periods. Such bleeding is not normal, and may not be related to a period at all.

The most common culprits for bleeding in between periods are the two conditions known as metrorrhagia and polymenorrhea. Metrorrhagia is bleeding from the uterus that is not related to menstruation at all, and is usually caused by disease and infection. Polymenorrhea is a kind  of irregular uterine bleeding that happens when the menstrual cycle is less than 21 days long. There are many different causes which  can trigger both metrorrhagia and polymenorrhea, which are listed below.

Some of the most common causes and factors of metrorrhagia and polymenorrhea:

• Age – Women who are just beginning their menstrual cycles or are approaching menopause are more susceptible to bleeding between periods.
• Medication – Birth control pills, blood thinners, and hormone replacements can increase intermittent bleeding. Missing a birth control pill is a frequent cause.
• Hormones – An imbalance in hormone levels can also cause bleeding between periods.
• IUD –  Spotting between periods is very common among women with an IUD.
• Ovulation – Some women experience spotting or bleeding every month at the time of ovulation, others only rarely.
• Pregnancy or miscarriage – Sometimes, women who do not know they are pregnant mistake a miscarriage for unusual bleeding between periods.
• Infections – Some sexually transmitted infections, such as Chlamydia,
• Polyps – In the cervix or uterus.
• Thyroid problems – An under-active thyroid can sometimes cause irregular periods.
• Ectopic pregnancy – Sometimes, the fertilized egg may begin to grow within the fallopian tube. This is a serious condition that can cause bleeding.
• Stress – While stress usually leads to a cessation or delay of periods, it can also cause irregular periods.
• Rarely, bleeding between periods can be caused by endometriosis, where the lining of the womb may reattach outside of the womb, or cancerous conditions in the cervix, uterus, or fallopian tubes.

How do I know if I have metrorrhagia or polymenorrhea?

The difference between the two is best diagnosed by a health care provider. In general, if what you are actually experiencing is a brief period in between your regular periods, and it is predictable, it is polymenorrhea. However, if the bleeding occurs without any rhyme or reason it is metrorrhagia.

How concerned should I be about bleeding between periods?

Intermenstrual bleeding is very common, seldom serious, and may require no treatment at all. However, you should consult your physician if any of the following are true.

• You have not yet begun to have regular menstrual cycles or are past menopause.
• You are pregnant or suspect you might be pregnant.
• The bleeding becomes heavy.
• There are other symptoms, such as pain in the pelvic or abdominal region.
• You have recently had an abortion or miscarriage.

What treatment is available for intermenstrual bleeding?

• Treatments depend on the cause. Often, no action is required. However, there are some possibilities your physician might recommend.
• Oral contraceptives – While these can cause the problem, they can also cure it. Pills come in different strengths and formulations, and these are often used to control bleeding if the patient is approaching menopause.
• Hormone therapy – Normally reserved for post-menopausal patients who have no other cause for the bleeding.
• In extreme cases, a partial or complete hysterectomy. If the cause is polyps or fibrous growths, surgical removal may be required.

What information will my doctor need to know?

• He or she will ask the normal questions, such as your age when you began menstruating or when they stopped and, if you are not past menopause, the date of your last period. You will be asked about any medication you are taking and any surgical procedures you may have had. Your doctor will also want to know how often you experience bleeding between periods and how long it typically lasts.
• Your physician may also ask the following questions.
• Does exercise affect the flow? Does it make it worse or better?
• Have you noticed any blood in your stool or urine?
• At what point in your cycle did the bleeding begin?
• Do you have any burning when urinating?
• If sexually active, do you always practice safe sex?
• Is there a chance you might be pregnant?
• Are you under stress?

Has there been any significant and unplanned change in your weight recently?

Bleeding between periods is usually little more than an annoyance. If it occurs frequently, becomes heavy, or if you just want the peace of mind, schedule an appointment with your physician. Only your medical provider can give you an absolute determination of the causes and treatments.