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.

• Hydatidiform Mole

  A hydatidiform mole or molar pregnancy is an abnormal pregnancy where there is overgrowth of placental tissue and typically no viable embryo or fetus can develop. This rare condition occurs early in pregnancy when abnormal cell growth is present in the placenta. The fetus will not develop, and the abnormal tissue must be removed. Patients with this condition are at risk for excessive bleeding, severe nausea and vomiting and early onset preeclampsia (high blood pressure with risk of seizure and other concerns). Early diagnosis and management is important.

• Uterine Cancer

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

• Cesarean Scar Syndrome
• Cervical Cancer
• Miscarriage
• Chlamydia Infection

Related Serious Diseases

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

• Sexual Trauma

  Genital trauma meaning injury to the genitals, can occur for a variety of reasons. Most often caused by sports injuries, accidents such as on a bicycle, or vigorous intercourse. Tears or injuries can also occur with childbirth. Sexual assault should also be considered.

• Placental Abruption
• Ectopic Pregnancy

Doctor's Diagnostic Questions

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

• Have you experienced vaginal bleeding or discharge outside of your periods or after menopause?
• How long have you had light pink/pink/brown/red discharge between periods?
• Have you had bleeding or colored vaginal discharge between periods?
• How has the vaginal bleeding changed since it started?

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/