Bleeding Between Periods: What it Means

May 6, 2016
Any woman can experience unexplained vaginal bleeding at some point during the reproductive phase of her life, so don’t be alarmed. Still, it’s a good idea to talk with your doctor.

Bleeding between periods is known in medical terms like “breakthrough bleeding”.

It usually serves as a warning sign for the woman experiencing it. This is because it can be one symptom of a more serious problem related to the reproductive system.

But while it’s necessarily normal, it also isn’t that unusual, and it doesn’t always indicate the possibility of a more dangerous condition.

That’s why it’s important that all women should inform themselves about this issue and its possible causes before they jump to any extreme conclusions.

All about bleeding through periods

menstrual-pain

A normal menstrual cycle usually varies between 21 to 35 days in length, with an average of 28 days.

The normal menstrual flow lasts for two to seven days, resulting in a total blood loss of 30 to 80 ml.

Abnormal bleeding occurs when there is a minor blood flow between the last day of the menstrual cycle and prior to the start of your next period.

It is thought that nearly all women may experience at least one episode of this “breakthrough bleeding”.  But in most cases, it’s not a cause for concern.

In spite of this, health experts and gynecologists recommend talking with your doctor if you experience this symptom.

It could indicate a more serious problem like cancer or another precancerous disorder.

See also: 5 things that affect the health of your ovaries

What can cause spotting between periods?

Ovulation

reproductive system
Ovulation is known to be one cause of abnormal blood flow between periods.

When you ovulate, your body increases its production of estrogen, the hormone that’s associated with the release of an egg from the ovary.

This surge of estrogen could cause the onset of breakthrough bleeding in between your periods, particularly if you notice it usually occurs between days 13 and 16 of your menstrual cycle.

Usually, in these cases, the color of blood can vary from pink to brown, and sometimes, by white cervical mucus and cramping sensations in the lower abdomen.

Stress

Physical and mental stress can also have a direct relationship with the onset of unusual bleeding.

Times of tension and stress cause triggers in the brain that can alter your normal menstrual cycle, leading to a brownish discharge in the days before or after your regular period.

Undiagnosed Pregnancy

ultrasound

It is not uncommon for a woman who is unaware she is pregnant to uncover the cause for the bleeding.

During the first few weeks of pregnancy, unexplained bleeding can occur when the embryo implants in the uterus.

But it’s important to see your doctor because this bleeding could also signal a miscarriage.

When should breakthrough bleeding be considered an emergency?

The bleeding between periods can be as heavy or heavier than your normal period, has an intense red, black, or brown color.

If it’s also accompanied by other symptoms like sweating, dizziness, arrhythmia, or abdominal pain, seek immediate medical attention.

If you are passing a lot of blood, but not more than you normally do during your period, it could indicate the presence of a myoma.

In any case, the presence of a considerable amount of blood between periods is best diagnosed through a proper medical examination. It will determine if its origin is the cervix, uterus, or vagina.

What does it mean when bleeding occurs after menopause?

menopause

The cessation of a woman’s menstrual periods is the signal that she has reached menopause.

But after a period of time without experiencing a regular blood flow, some women may notice spotting or the presence of even larger quantities of blood. It can be a warning sign.

This type of unusual bleeding may be due to a fibroid or polyp, but in most cases, it’s an early symptom of a precancerous lesion or cancer itself.

We recommend you read: Symptoms of Colon Cancer in Women

What tests should be done?

One of the most common tests for gynecological abnormalities is the Pap smear.

Results show whether the bleeding is coming from the uterus and if there are cancerous cells present in the cervix.

An ultrasound is a highly sensitive diagnostic test that can detect potential changes in the uterus and ovaries.

However, if these are not enough to dispel any doubts, the last resort is usually a hysteroscopy.

It involves inserting a small camera into the uterus through the vagina to study it in more detail.

  • American College of Obstetricians and Gynecologists. ACOG Committee Opinion No 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Obstet Gynecol. 2013; 121 (4): 891-896. PMID: 23635706.
  • Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: chap 17.
  • Ryntz T, Lobo RA. Abnormal uterine bleeding. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017: chap 26.