Bleeding Between Periods

About the Symptom

Bleeding that occurs in between a normal menstrual cycle. Irregular and unpredictable period bleeding is considered abnormal and should be investigated.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

• Abdominal pain
• Lower abdominal pain
• Menstrual abnormality (duration or volume)
• Low back pain
• Fever

Possible Causes

Generally, Bleeding between periods can be related to:

• Ovulation Bleeding

  Ovulation is the process when the ovary releases an egg as part of the normal female reproductive cycle. It typically happens in the middle of a menstrual cycle (about 2 weeks after the end of the period). At the time of ovulation, some women may feel some cramping or lower abdominal pain that resolves by itself. This is called mid-cycle pain (mittelschmerz), and it can occasionally cause some mild bleeding or spotting along with it. If there is no other cause for the pain or bleeding, this is not considered to be harmful.

• Uterine Cancer

  The vast majority of women develop post-menopausal bleeding as their first symptom of uterine cancer or cancer of the womb. Risk factors include age, with most cases appearing after menopause, a history of estrogen-only hormone treatment, and obesity. Diagnosis is after a pelvic exam, ultrasound, biopsy and other scans to determine whether the cancer has spread.

• Cesarean Scar Syndrome

  This complication occurs in women who have had a cesarean section and the muscle layer of the uterus fails to heal properly in that area. Another name for this condition is cesarean scar defect or uterine niche. It can in some cases cause abnormal vaginal bleeding, pain, and infertility.

• Cervical Cancer
• Hydatidiform Mole
• Luteal Insufficiency
• Atrophic Vaginitis

Related Serious Diseases

Sometimes, Bleeding between periods may be related to these serious diseases:

• Placental Abruption

  This is a condition during pregnancy where the placenta separates from the uterus before the fetus is born. Since the placenta is rich in blood supply and provides oxygen and nutrients to the fetus, separation can result in significant vaginal bleeding and cut off oxygen supply to the fetus, endangering both mother and child. Common causes include abdominal trauma in pregnancy such as being in a motor vehicle accident or falling on your abdomen. Other causes are also possible. Symptoms typically include vaginal bleeding and abdominal or pelvic pain similar to contractions. Any such concerns in pregnancy should seek emergency care.

• Ectopic Pregnancy
• Sexual Trauma

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

• Have you experienced any vaginal bleeding or unusual discharge outside of your period?
• When did you first notice vaginal bleeding or discolored discharge outside of your period?
• How often do you experience vaginal bleeding or discolored discharge outside of your period?
• How is your vaginal bleeding or discolored discharge outside of your period now?

FAQs

Find Similar Symptoms

References

• ACOG Patient FAQ - Abnormal Uterine Bleeding

  https://www.acog.org/womens-health/faqs/abnormal-uterine-bleeding

• Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign

• Davis E, Sparzak PB. Abnormal Uterine Bleeding. [Updated 2022 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan

  https://www.ncbi.nlm.nih.gov/books/NBK532913/