Intermenstrual Bleeding - Description and Treatment

04 June, 2020
Intermenstrual bleeding is the vaginal bleeding that happens between menstrual periods. You must consult your doctor if this occurs in order to obtain a timely and accurate diagnosis. Continue reading to find out why.

Are you experiencing intermenstrual bleeding? If so, then you must know why it happens and what the available treatments are.

Intermenstrual bleeding, the kind of vaginal bleeding that happens between menstrual periods, is also known as metrorrhagia. Regular menstruation usually lasts about 3 to 7 days and, depending on the woman, there are 24 to 35 non-bleeding days. So, metrorrhagia is any loss of vaginal blood during the regular non-bleeding interval.

What’s intermenstrual bleeding?

Studies reveal that metrorrhagia is one of the most common causes of genital bleeding among women of reproductive age. It’s also one of the most common causes of anemia. It comes from the uterus when there’s neither a presence of organic pathologies nor a pregnancy. Therefore, it isn’t easy to identify the cause.

A woman with abdominal pain.
The kind of intermenstrual bleeding that doesn’t seem to have a specific cause, such as pregnancy, is known as metrorrhagia.

What are the causes?

Intermenstrual bleeding can be due to various pathologies and problems; the good news is that there are treatments for it. Some of the most common causes are:

  • Endometrial hyperplasia. This is when the endometrium (the mucous membrane that lines the uterus) enlarges and causes bleeding. It’s usually due to high levels of estrogen and low levels of progesterone.
  • Cervicitis (an inflamed cervix)
  • Fibroids and polyps. These are tumors that grow inside the uterus; most of them are benign, though.
  • Sexually transmitted infections (STIs), such as chlamydia or gonorrhea
  • Vaginal opening lesions which can arise as a result of trauma, sexual intercourse, infection, genital warts, and polyps
  • Hypothyroidism, hormonal changes, and other disorders associated with menstruation
  • An ectopic pregnancy (when the embryo implants outside the uterus)
  • A miscarriage usually comes along with tissue and cramps
  • Menopause. Bleeding could result from vaginal dryness, produced by a drastic decrease in estrogens.
  • Hormones in estrogen treatments and the use of birth control pills or the intrauterine device (IUD)
  • Anticoagulant medication abuse

A doctor must rule out blood in urine or the rectum in order to diagnose metrorrhagia. That is, the bleeding must be vaginal.

You may be interested: What Are Uterine Fibroids and How Are They Treated?

Intermenstrual bleeding diagnosis

A woman consulting a doctor.
In the presence of irregular bleeding, it’s important to go to the gynecologist and undergo the appropriate examinations.

A doctor can indicate blood and other similar tests in order to gradually dismiss other problems and establish a proper diagnosis. For example, a blood test would check a person’s hormone levels, while an ultrasound would examine their uterus. Likewise, they could rule out sexually transmitted diseases through a pap smear.

Research on this subject has also emphasized that metrorrhagia is related to obesity. They must rule out organic pathologies (vulvar, vaginal, cervical, fibroids, polyps, pelvic tumors, among others) in order to make a successful clinical diagnosis.

Also read: Bleeding Between Periods: What it Means

What’s the treatment for intermenstrual bleeding?

Intermenstrual bleeding treatment will depend on its origin. That is, the doctor will establish it after identifying the cause. Your doctor may prescribe certain hormones, such as estrogens or progesterone if the cause has to do with menopause.

In addition, a doctor may change the method or the medication if bleeding is due to the use of an IUD or any other contraception method. They can also prescribe drugs for the treatment of sexually transmitted diseases, if applicable.

Similarly, surgery may be necessary if polyps, miscarriage, tumors, or an ectopic pregnancy are the causes of intermenstrual bleeding. Medical literature also mentions that treatment for it focuses on the following three goals:

  • Restraining bleeding
  • Regulating the menstrual cycle
  • Treating iron deficiencies and anemia

Doctors recommend that women maintain a record of their menstrual cycles and note any irregularities. This information will make it easier for a specialist to detect problems or diseases and treat them early on.

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  • Carolina Schulin-zeuthen, D. P., & Carolina Conejero, D. R. (2011). Trastornos Menstruales Y Dismenorrea En La Adolescencia Menstrual Disorders and Dysmenorrhea in Adolescents. Revista Médica Clínica Las Condes. https://doi.org/10.1016/S0716-8640(11)70391-1
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  • Giordano, M. G. (1992). Ciclo menstrual. Femina.
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  • Montejo Rodriguez, R., González Soroo, M. D., Muruzábal Torquemada, J. C., & Martínez Montero, J. (2002). Protocolo diagnóstico de la metrorragia. Medicine – Programa de Formación Médica Continuada Acreditado. https://doi.org/10.1016/s0304-5412(02)70815-9