Vaginal bleeding or spotting between periods is more common than you think. Also known as intermenstrual bleeding, spotting, and metrorrhagia, this condition can be distressing and often cause confusion. There are multiple causes of experiencing vaginal bleeding between periods, including stress, pharmaceutical side effects, and certain medical issues. While some causes are easy to treat, others might point to a dangerous underlying illness. It is vital to visit your doctor for testing, diagnosis and treatment options if you experience heavy bleeding between periods.

What is vaginal bleeding between periods?

Vaginal bleeding between periods, also known as intermenstrual bleeding or spotting, is a vaginal bleeding that occurs outside of a woman’s regular menstrual period. It can be caused by a variety of factors, ranging from hormonal imbalances to more serious conditions like infections or tumours. This can include light spotting or a heavier flow that resembles a period, found in a study published in the StatPearls Journal.

Monitoring your symptoms and seeking medical advice when necessary is important for maintaining reproductive health. Regular check-ups and open communication with your healthcare provider can help identify any issues.

Causes of vaginal bleeding between periods

Here are some of the common causes of vaginal bleeding between periods that you should know:

1. Hormonal imbalances

“Hormonal imbalances are a frequent cause of intermenstrual bleeding. Fluctuations in estrogen and progesterone levels can disrupt the regular menstrual cycle, leading to unexpected bleeding. The endometrium or lining inside the uterus sheds because of fluctuations in estrogen and progesterone,” says gynaecologist and obstetrician Dr Madhu Juneja.

2. Birth control

Hormonal contraceptives, such as birth control pills, patches, injections, or intrauterine devices (IUDs), can sometimes cause spotting, especially when first starting them or if doses are missed, found a study published in the Journal of Contraception. A general advice is to monitor the first 3 cycles after starting a new drug. It is imperative to seek advice from a doctor to avoid abnormal vaginal bleeding during periods.

3. Uterine fibroids or polyps

“Benign growths in the uterus, such as fibroids or polyps, can cause bleeding between periods. These growths can vary in size and may lead to other symptoms such as heavy menstrual bleeding and pelvic pain. Diagnosis of such a condition at an earlier stage can be medically managed, explains the expert.

4. Ovulation

Some women experience light bleeding or spotting during ovulation, this bleeding is usually about halfway through the menstrual cycle, according to a study published in the American Journal of Epidemiology. This is often due to the sudden drop in estrogen that can occur at this time.

5. Infections

Infections of the reproductive organs, including sexually transmitted infections (STIs) like chlamydia or gonorrhea, can cause abnormal bleeding, as found in a study published in the StatPearls Journal. Pelvic inflammatory disease (PID) can also lead to bleeding between periods. However, more research is needed to prove the claim.

6. Stress

High levels of physical or emotional stress can affect hormonal balance and lead to irregular bleeding. People working in a corporate environment should have peer groups to minimise work stress and prevent deterioration of health issues, recommends the expert.

7. Medications

Certain medications, such as blood thinners, can lead to intermenstrual bleeding. Even over-the-counter medications, like nonsteroidal anti-inflammatory drugs (NSAIDs), can sometimes contribute to vaginal bleeding between periods.

What are the symptoms of vaginal bleeding between periods?

Here are the common symptoms associated with this condition, as explained by the expert.

Common symptoms

1. Light spotting

Light bleeding that is less heavy than a regular menstrual period. It may appear as pink, red, or brown discharge, however from one person to another.

2. Heavier bleeding

In some cases, the bleeding between periods can be heavier and resemble a regular menstrual flow. A tracker or menstrual calendar may help take wise advice from your doctor.

3. Irregular timing

The bleeding occurs at times unrelated to the normal menstrual cycle, often unexpectedly.

4. Pelvic pain or cramping

Some women may experience mild to moderate pelvic pain or cramping along with the bleeding commonly known as Mittle Schemers syndrome.

5. Vaginal discharge

Changes in vaginal discharge, such as an increase in volume or changes in colour and consistency, can accompany intermenstrual bleeding. It may be associated with a foul smell or internal infection due to a change in vaginal flora (microorganisms that colonise the vagina).

6. Bleeding after sexual intercourse

Some women may notice spotting or bleeding following sexual intercourse. If that’s the case, connect with your doctor immediately for evaluation, which may include a pap smear test.

7. Bleeding after menopause

Postmenopausal bleeding is a concerning symptom and should be evaluated by a healthcare provider.

Other symptoms

Depending on the underlying cause of the bleeding, other symptoms may also be present, including:

1. Fatigue

Feeling unusually tired or weak, which can be related to blood loss or anaemia.

2. Dizziness or light-headedness

Feeling faint or lightheaded, especially if the bleeding is heavy or lasts long.

3. Pain during intercourse

Discomfort or pain during sexual activity may accompany the bleeding.

4. Frequent or painful urination

You should also look out for symptoms of urinary tract infections or other urinary issues such as painful urination.

5. Abdominal or lower back pain

If you experience persistent pain in the lower abdomen or back, it could be due to vaginal bleeding between periods.

6. Fever or chills

Signs of an infection may be associated with pelvic inflammatory disease (PID) or other reproductive tract infections.

7. Changes in menstrual cycle

Alterations in the regularity, duration, or flow of menstrual periods.

How to prevent vaginal bleeding between periods?

Preventing vaginal bleeding between periods involves a combination of lifestyle adjustments, regular medical check-ups, and addressing any underlying health conditions. Here are detailed tips to help prevent intermenstrual bleeding, as explained by the expert.

1. Maintain a healthy lifestyle

Eat a nutritious diet rich in fruits, vegetables, lean proteins, and whole grains. Ensure adequate intake of iron and vitamins to support overall reproductive health. Avoid excessive consumption of processed foods, caffeine, and alcohol, which can disrupt hormonal balance.

2. Regular exercise

Engage in regular physical activity to maintain a healthy weight and reduce stress. Aim for at least 30 minutes of moderate exercise most days of the week. Avoid excessive exercise, which can disrupt your menstrual cycle.

3. Manage stress levels

Practice stress-reducing techniques such as yoga, meditation, deep breathing exercises, and hobbies you enjoy. High stress levels can impact hormonal balance and menstrual irregularity.

4. Use contraceptives correctly

If you take hormonal contraceptives, it is best to follow your healthcare provider’s instructions carefully. Missing doses or not taking them consistently can cause hormonal imbalances and irregular bleeding. Discuss with your doctor about the best type of contraceptive for you, as some may cause more spotting or irregular bleeding than others.

5. Monitor menstrual cycle

Use a calendar or a menstrual tracking app to keep a record of your menstrual cycle, including the start and end dates, flow intensity, and any instances of spotting or irregular bleeding. Being aware of your cycle patterns helps in identifying any abnormalities early.

6. Avoid painful sexual practices

Use lubrication during intercourse to avoid vaginal trauma, which can cause bleeding. Ensure adequate foreplay and communicate with your partner to prevent rough or painful intercourse. Screen for cervical health through Pap smears regularly, especially if you have risk factors such as a history of HPV infection or multiple sexual partners.

Takeaway

Preventing vaginal bleeding between periods requires a proactive approach to overall health and well-being. Maintaining a balanced lifestyle, using contraceptives correctly, monitoring your menstrual cycle, and seeking regular medical care are crucial steps. By addressing any underlying conditions promptly and following your healthcare provider’s advice, you can reduce the likelihood of intermenstrual bleeding and ensure better reproductive health.