Bleeding between periods
Normally a period lasts for an average of 4 days and occurs normally every 28 days (plus minus 7 days). Bleeding between two periods and after the is abnormal and may be because of several causes, which are treatable and usually benign. Vaginal bleeding may be due to cancer or pre-cancer. So it is necessary to to evaluate any form of abnormal bleeding.
Causes of bleeding between periods
Hormonal imbalance: An imbalance between oestrogen and progesterone hormone causes spotting. Dysfunctional ovaries or polycystic ovarian syndrome, thyroid gland disorders, starting or stopping birth control pills, can all affect your hormone balance.
Intrauterine device: a plastic device inserted into the uterus and can cause abnormal bleeding.
Taking emergency contraceptive pills
A recent abortion
Pregnancy complication: During pregnancy, any form of spotting must be checked. Slight bleeding during implantation is normal and yet it must be checked. Miscarriage and ectopic pregnancy (where fertilised egg implants outside the uterus usually in the fallopian tubes)- can cause bleeding.
Infection: Any infection can cause inflammation and bleeding. Infection may occur after intercourse, douching , or may be due to pelvic inflammatory diseases or STI. In pelvic inflammatory disease there is marked inflammation of the reproductive organs leading to scarring.
Uterine fibroids or polyps: These are non-cancerous growths that form in the uterus. These can cause bleeding.
Cancer: Less commonly cancer of cervix, vagina, uterus or ovaries may cause bleeding
Rare causes: stress, diabetes, bleeding disorders, diabetes, use of blood thinners.
Irregular bleeding, such as bleeding between periods, is common during the first three months of starting hormonal contraception, such as the:
If you’re concerned about bleeding, or it lasts longer than three months, you should seek medical advice.
You may also bleed between periods if you:
- have a problem with your patch or vaginal ring
- have taken antibiotics, prescription medicine and you’re on the pill, patch, ring or implant
- miss out your pill-, patch- or ring-free week- when you are not taking the pill, or wearing the patch or ring.
Any form of heavy bleeding must be checked and evaluated by a professional. Keep a track of the number of pads that you used over time so that the amount of bleeding can be determined, how often you need to change the pad and how soaked the pads are.
When to seek medical advice
If you’re concerned about your bleeding, you should see your doctor if
- you are pregnant
- any unexpected bleeding between periods
- bleeding after the menopause
- heavy bleeding with periods
- abnormal bleeding with dizziness, fatigue
A healthcare professional will talk to you about your symptoms. Depending on your situation, they may suggest carrying out some tests, such as:
- a pregnancy test
- a cervical screening test, if you’re aged 25-64 and not up-to-date with these
- an ultrasound scan
- tests for STIs, which may include an examination of your genitals
To diagnose some conditions, you may need an examination, such as:
- a speculum examination – a speculum is a medical instrument that is inserted into your vagina
- an internal examination of your vagina with the fingers (bimanual examination)
The examination processes may be difficult and slightly painful for you. It is best if you relax and cooperate with the doctor. This is how you can ensure that all examinations are correctly done will minimum discomfort.