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Intermenstrual Bleeding or Spotting - Is it Normal or Should I be Worried?

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Intermenstrual Bleeding or Spotting - Is it Normal or Should I be Worried?

3 min read


Intermenstrual vaginal bleeding or spotting or bleeding between periods is considered abnormal and may usually require a patient to see a doctor.

Medically reviewed by

Dr. P. C. Pavithra Pattu

Published At October 28, 2013
Reviewed AtAugust 1, 2023

What Are the Causes of Intermenstrual Bleeding?

Causes of Intermenstrual bleeding:

Intermenstrual bleeding or bleeding between periods can be caused by a vast number of factors which may be physical or organic and psychosocial. If you are experiencing intermenstrual bleeding, then your doctor maybe a able to rule out one of the below most probable types of causes (from most likely to least likely):

  • Complicated Pregnancy: Several early pregnancy complications exist such as ectopic pregnancies, miscarriage, implantation bleeding (not actually a complication but rather a natural physiologic process that leads to spotting) etc. These complications can lead to intermenstrual bleeding or spotting. Your doctor will need to rule that out first.
  • Infection: This is one of the most common causes of bleeding between period. Pelvic infections or inflammations such as PID, cervicitis, vaginitis, endometritis, septic abortions, STDs etc can lead to vaginal bleedings between periods.
  • Uterine Fibroids or Polyps: These are uterine growths or masses, that are benign or non-cancerous and even though the majority are not symptomatic, but usually can present with instermenstrual bleeding.
  • Ovarian Cysts: PCOS/PCOD can lead to intermenstrual bleeding and it is one of the leading causes of bleeding in young women.
  • Hormonal Imbalance: Gonadotrophic hormones such as estrogen and progesterone (natural hormones secreted by the female gonads) could become abnormally secreted in the blood stream and hence lead to abnormal vaginal bleeding. Other hormonal systems that influence secretion of these hormones could also be affected, hence contribute to this disorder. Other underlying diseases conditions are usually associated to this.
  • Intrauterine Device: Women that happen to use IUD or intrauterine devices as primary birth control method, can experience intermenstrual bleeding.
  • Cancer: Rare and usually occurs in older women. Uterine, ovarian, cervical cancers etc
  • Rare Causes: Other rarer causes of intermenstrual bleeding exist such as menopause, endometriosis, stress, change in diet plan, trauma, post-coital bleeding, obesity, birth control pills/injections etc

When to See a Doctor?

Even though it is always wise to seek your doctor's opinion when ever you experience an abnormal vaginal bleeding, but it is not always necessary. It is best you observe for persistence (when bleeding is severe) or reoccurence, then you can then seek doctor's opinion. Other symptoms might also guide you in making the decision (quick enough) to see your doctor or health care provider, such as lower abdominal pain, heavy bleeding, dizziness, fatigue, fever.

At Doctor's Consultation:

  • You might be required to answer a wide range of questions surrounding especially the bleeding i.e from time of onset, duration, if other previous episodes, associated symptoms with doctor including as much of your gyneco-obstetric history as possible.
  • After which, your doctor will then conduct a full physical exams with especially a pelvic exams.
  • Specific diagnostic (laboratory and imagery) tests can then be conducted based on the data your doctor has collected. You should expect tests such as complete blood count, STD screening (TPHA/VDRL/ chlamydia IgG, vaginal spear, paps smear), urinalysis, pregnancy tests and pelvic ultrasound or scan. All these aimed at determining the cause of your bleeding. In some cases, analysis of serum levels of estrogen and progesterone might be necessary.
  • Once the cause is established, your doctor (most likely a gynecologist) will provide you with an appropriate treatment. In some cases, you might be expected to undergo a surgical procedure.

What Are the Complications of Intermenstrual Bleeding?

Complications of Persistent Intermenstrual Bleeding:

Several complications can arise from a neglected persistent or recurrent intermenstrual bleeding such as:

  • Anemia.
  • Hemorrhagic shock.
  • Infection.
  • Metastatic cancers.
  • Miscarriage.

In most cases, spotting or intermenstrual bleeding resolves on its own without medical intervention.

How to Prevent Intermenstrual Bleeding?

  • It will be hard to tell which exact method is good to prevent intermenstrual bleeding given that they are various possible causes. So, the method will depend on the cause, therefore;
  • If you suspect that your pregnant, it is best to start your ANC as soon as possible so a complete evaluation of your pregnancy can be done and prophylactic treatments initiated soon enough.
  • From time to time (especially if you practice unprotected sex with multiple partners), it is best you do repeat screen of STDs so they can be detected earlier and treated.
  • Do screen for pelvic cancers such as uterine, ovarian, cervical cancers, say ones every year or 2-3 years interval.
  • Generally maintain healthy lifestyle, seek doctor's opinion if you suspect medication or IUD responsible for the bleeding.

Frequently Asked Questions


How Long Does Bleeding Between Periods Usually Last?

Intermenstrual bleeding is also referred to as vaginal bleeding between periods or acute bleeding. It is the bleeding from the uterus which does not represent the normal period. This can occur 10 to 16 days after the last menstruation. There will usually be minimal bleeding, which can last from 12 to 72 hours.


Can Intermenstrual Bleeding Be Caused Due to Stress?

Stress can cause all types of changes in your body. Therefore, women who undergo a large amount of physical or emotional stress can experience bleeding outside of their regular menstrual cycle. This process is referred to as breakthrough bleeding, which occurs in response to a high-stress level.


How Prevalent Is Intermenstrual Bleeding?

Intermenstrual bleeding is the most common complaint among women under the age of 40 years. It can occur due to infection of the cervix or the uterus, injury or disease of the vaginal opening caused due to infection, intercourse, polyp, trauma, ulcers, genital warts or varicose veins, or ovulation. Ovulation bleeding occurs at the time of ovulation in the middle of the menstrual cycle. Still, in a study, it has been found that only 5 % of women will experience spotting or bleeding in between their periods due to ovulation.


Why Do I Have Brown Vaginal Bleeding Between Periods?

Spotting or brown bleeding can occur during ovulation or between the periods. Sometimes you may get brown discharge during the early pregnancy at the time of the period, which would normally come. The brown blood may look drier, thicker, and clumpier than regular; this can be due to oxidation, which is the usual process.


How to Stop Hormonal Bleeding Naturally?

To stop hormonal bleeding naturally, you can use:
- Fennel, which has analgesic and anti-inflammatory properties, reduces menstrual symptoms and decreases blood flow length during your period.
- Ginger, to alleviate heavy bleeding.
- Myrtle fruit syrup to overcome heavy menstruation.
- Raspberry leaf has a muscle-relaxing property that can reduce uterine contractions.


How Serious and Common Is Intermenstrual Bleeding?

Intermenstrual bleeding can occur due to various problems, but most are benign and can be easily treated, and others may denote some serious underlying cause.


How to Stop Irregular Bleeding?

To stop bleeding, you can take:
- Birth control pills and other hormone treatments may give you regular menstrual cycles and lighter periods.
- Gonadotropin-releasing hormone agonists (GnRHa) stop your body from making certain hormones.
- Tranexamic acid.
- NSAIDs (Nonsteroidal anti-inflammatory drug).
- IUD (intrauterine device).


What Is the Best Medicine to Arrest Bleeding?

Gonadotropin-releasing hormone, or GnRH, agonist, is the best medication useful to stop menstrual bleeding. This drug imitates a hormone in the human body produced in the pituitary gland in the brain. This hormone will stimulate the ovaries to develop eggs and produce estrogen, which enables the menstrual cycle.


Can Intermenstrual Bleeding Be Caused by PCOS?

PCOS (polycystic ovary syndrome) is the most commonly occurring hormonal problem among women of childbearing age. PCOS can cause numerous symptoms like intermenstrual bleeding or irregular bleeding.


Can Spotting Indicate That You Are Pregnant?

Women can have bleeding or spotting during early pregnancy, which is considered a normal part of the pregnancy. It can occur in 20 % of pregnancies, and most of these women will have healthy pregnancies.


How Do You Differentiate Between Pregnancy Spotting and Periods?

The main difference between spotting and periods is the amount of blood that gets expelled. Periods can occur for several days, usually from 5 to 7 days, that requires a pad or a tampon to absorb the flow. But, in the case of spotting, only a small quantity of blood gets expelled, and it does not require any of these products to control.


When to Approach a Doctor for Spotting Between Periods?

It is usual to have bleeding during the first trimester. According to a study, 30 % of women can have bleeding or spotting during early pregnancy, which is considered a normal part of the pregnancy. But if you have cramps or pelvic pain with clots and active bleeding, you need to seek medical advice because something might be wrong.
Dr. NSAH Bernard
Dr. NSAH Bernard

Family Physician


metrorrhagiaintermenstrual bleedingmiscarriagepregnancy complications
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