Bleeding Between Periods: What it Means

November 11, 2019
Any woman can experience unexplained vaginal bleeding at any point during her reproductive life. Although it's no cause for alarm, it's always a good idea to consult a doctor.

Vaginal bleeding occurs between one menstrual cycle and another. The medical term for bleeding between periods is “intermenstrual bleeding”. It’s normally associated with symptoms of serious female reproductive system diseases. Thus, bleeding between periods is usually a warning sign.

Although they aren’t necessarily normal, bleeding between periods also isn’t uncommon and doesn’t always indicate the existence of a more dangerous condition.

In this sense, it’s important that all women inform themselves about this issue and its possible causes before jumping to any extreme conclusions.

All about bleeding between periods

A woman with menstrual cramps.

A normal menstrual cycle usually lasts between 21 to 35 days, with an average of 28 days. 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’s a minor blood flow between the last day of the menstrual cycle and prior to the start of your next period.

It’s believed that nearly all women may experience at least one episode during their reproductive lives. But in most cases, it’s not a cause for concern.

In spite of this, health experts and gynecologists recommend talking to your doctor if you experience this symptom. This way, they can rule out that the bleeding is caused by a more serious problem, such as cancer or another precancerous disorder.

To learn more, you can also read: 5 Things that Affect the Health of Your Ovaries

What can cause bleeding between periods?

Ovulation

The female reproductive system.

Ovulation is known to be one cause of abnormal bleeding between periods.

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 the flow can vary from pink to brown. Sometimes, it’s accompanied by white cervical mucus and abdominal cramps.

Stress

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

A stressful situation can trigger a brain response that can alter your menstrual cycle, leading to a brownish discharge in the days before or after your regular period.

Undiagnosed pregnancy

An ultrasound.

It’s likely that a woman who doesn’t know she’s pregnant will uncover it when she goes to the doctor due to the bleeding.

During the first few weeks of pregnancy, unexplained minor bleeding can occur. Many times, it’s caused by embryo implantation in the uterus. Nevertheless, it’s important to see your doctor because this bleeding could also be a symptom of miscarriage.

When should bleeding between periods be treated immediately?

If the bleeding between periods is as heavy or heavier than your normal period and has an intense red, black, or brown color, you should go to the emergency room. If you also have other symptoms such as sweating, dizziness, arrhythmia, or abdominal pain, seek immediate medical attention.

In addition, if you’re passing a lot of blood, but not more than you normally do during your period, you may have a uterine fibroid. However, you should go see your doctor if you’re suffering from considerable bleeding between periods. The medical professional will determine if the blood is coming from the cervix, uterus, or vagina.

When bleeding occurs after menopause

A woman who is going through menopause.

The cessation of a woman’s menstrual periods is the signal that she’s reached menopauseHowever, after a period of time without periods, some women may notice spotting or even larger quantities of blood.

This type of unusual bleeding may be due to a uterine fibroid or polyp. In many cases, it’s a warning sign of a precancerous lesion or cancer.

If you want to know more, we recommend you read: The Prevention of Uterine Cancer Cases

What tests should be done?

One of the most common tests for gynecological abnormalities is the Pap smear. The results allow specialists to know if the bleeding is coming from the uterus and if there are cancerous cells in the cervix.

An ultrasound is another test that can detect potential changes in the uterus and ovaries.

If these aren’t 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.