What Is Abnormal Vaginal Bleeding?
Most women will experience bleeding between periods sometime in their lives, often more than once. This can manifest as light bleeding before expected period, spotting, or even heavy flow. However, it is not a regular part of the menstrual cycle. Abnormal vaginal bleeding is when the bleeding occurs:
- Before the period, or afterward
- When the menstrual flow is lighter or heavier than usual
- At an unexpected time, such as during pregnancy, menopause, or before the age of nine
Abnormal vaginal bleeding is also called intermenstrual bleeding or metrorrhagia. At the same time, spotting refers to light bleeding before expected period. By itself, vaginal bleeding between periods is not usually a cause for concern. However, it may be an indicator of another serious condition.
How Common is Abnormal Vaginal Bleeding?
Vaginal bleeding between periods is common, especially when a woman reaches childbearing age. You are likely to experience this at some point in your life, often more than once. Some may notice light bleeding before expected period. Others may have heavier flow than usual. Abnormal bleeding accounts for 25% of gynecologic surgeries.
What Are the Symptoms of Abnormal Vaginal Bleeding?
The signs and symptoms of abnormal vaginal bleeding may vary. Some women may experience light bleeding before expected period. The other most common symptoms of abnormal vaginal bleeding include:
- Bleeding at unusual times, such as during pregnancy, after intercourse, and during menopause
- Heavier flow than usual (menorrhagia)
- Longer periods that last more than seven days
- Inconsistent menstrual cycles and missed periods
- Fatigue and dizziness
- Fever and chillds
- Pelvic or lower abdominal pain
- Abnormal vaginal discharge
When Should I See the Doctor?
Vaginal bleeding between periods is common. Some women may notice light bleeding before expected period. Others may experience heavier flow than normal. Consult your doctor if you start to experience symptoms and if the bleeding becomes unbearable. Make an appointment to determine the cause, along with its correct treatment.
Causes & Risk Factors
The Phases of the Menstrual Cycle, Explained
The average menstrual cycle occurs every 21 to 35 days and lasts from three to seven days. Vaginal bleeding between periods, while common, is not normal. When this happens, women may experience light bleeding before expected period, and maybe even after. Vaginal bleeding can have multiple causes, some of which include:
Hormonal Imbalances
Women may notice light bleeding before the expected period due to hormonal changes. When there is an imbalance in the production of estrogen and progesterone (hormones regulating menstrual cycle), spotting may occur. The following are possible causes of the imbalance:
- Dysfunctional ovaries. For example, polycystic ovarian syndrome (PCOS) is due to an overproduction of male hormones, which affects the balance of hormone levels in the body. Women with PCOS experience irregular periods or none at all.
- Problems with thyroid glands, which causes menstrual irregularities
Bleeding in between periods can also occur during and after using hormonal contraceptives. The additional hormones can cause changes in the uterus lining. Bleeding or spotting may occur in the first three months of usage, according to research. These contraceptives include:
Infection
Vaginal bleeding due to an infection is often an indicator of problems within the reproductive organs. Infections include:
- Sexually transmitted infections. For example, chlamydia can cause bleeding during or after intercourse.
- Pelvic inflammatory disease. This is an inflammation of the reproductive organs, which leads to scarring.
Pregnancy complications
Spotting or light bleeding can still occur during pregnancy. At the same time, if you experience heavy bleeding that resembles a period, it can indicate either a miscarriage or an ectopic pregnancy. Any type of bleeding before and during pregnancy should be evaluated by a doctor immediately.
Uterine fibroids
Fibroids are muscular tumors that grow along the walls of the uterus. These are usually benign or non-cancerous. There are other chronic conditions, which also affect the uterus like endometriosis. Heavy bleeding and cramping are two symptoms of uterine fibroids.
Cancer
Vaginal bleeding between periods can also indicate cancer. These include cancer in the uterus lining, cervix, and vagina. Cervical cancer, for example, is a common condition among women ages 30 to 45 years old. This is usually marked by light bleeding before expected period or after sex. Women who already have gone through menopause are more likely to get diagnosed.
Other causes
Vaginal bleeding between periods can also be caused by foreign body reaction in the vagina (tampons or condoms) or even emotional stress.
Risk Factors
What Increases My Risk for Abnormal Vaginal Bleeding?
There are many risk factors for vaginal bleeding between periods. These include:
- Obesity. High fat deposits can disrupt normal menstrual cycles. These fat tissues can become estrogen, which causes heavy bleeding.
- Eating disorders. Women who are anorexic or bulimic, as well as those who do crash diets, are likely to experience abnormal bleeding. These can disrupt normal ovulatory function.
- Health problems. The chance of experiencing light bleeding before expected period increases due to underlying health conditions. These include PCOS, infections, thyroid disorders, and certain cancers.
- Birth control use. Women are likely to experience spotting when using certain contraceptives. This will usually occur during the first three months of intake. Bleeding can also happen if the frequency of intake changes.
- Perimenopause or menopause. During this stage, the woman’s uterus lining becomes thicker, which can result in spotting.
Diagnosis & Treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is Abnormal Vaginal Bleeding Diagnosed?
It is important to disclose all your symptoms to your doctor once you get checked for vaginal bleeding in between periods. Your doctor will ask about the volume and duration of bleeding to help quantify total or ongoing blood loss, and will also ask about your menstrual history.
It is helpful to keep track of your menstrual cycle, including the duration and heaviness of your flow. Your doctor will also ask about your medical history and medications you currently use.
Afterward, a physical exam will be performed, including a pelvic exam. This will examine the different reproductive organs for possible defects. These include the vagina, cervix, fallopian tubes, and uterus.
To further determine what may be causing your bleeding, diagnostic tests may also be ordered. Some of these may include:
- Blood test. This is used to check hormone levels.
- Biopsy. A sample of tissue is taken from the cervix or lining of the uterus for testing. This will help rule out possible infections and diseases
- Ultrasound. This will give your doctor a look at your reproductive organs. Structural defects and abnormalities can be identified through this procedure.
- Cervical smear and swabs. A sample of your cells are taken to be evaluated for infection.
- Hysteroscopy. This involves inserting a thin, lighted tube into the cervix to examine the uterus.
How is Abnormal Vaginal Bleeding Treated?
Treatment usually depends on the underlying cause. This is why it is important to take note of signs and symptoms, such as light bleeding before expected period, or heavier flow than usual. Vaginal bleeding between periods can be managed or treated with the following:
- Antibiotics
- Anti-inflammatory drugs
- Change in birth control pills or contraceptives used
- Hormone therapy
- Surgery to remove fibroids and tumors
For proper diagnosis and treatment, consult your OB-GYN.
Lifestyle Changes & Home Remedies
What are some lifestyle changes or home remedies that can help me manage vaginal bleeding between periods?
Most of the time, vaginal bleeding between periods can be recurring. How you treat or manage it depends on the cause. However, there are other preventive measures you can do, including:
Maintaining a healthy lifestyle. This includes exercise and proper diet. You may also want to maintain a normal weight since additional fat deposits can disrupt your menstrual cycle.
Ice packs. Putting ice packs on your abdomen can provide pain relief, especially during heavy bleeding.
Painkillers. Painkillers such as ibuprofen or paracetamol can help manage pain. However, aspirin should be avoided. Studies show that frequent aspirin intake can increase bleeding tendencies.
Vitamins and minerals. For example, high levels of iron can reduce heavier periods. On the other hand, vitamin C helps strengthen blood vessels and the absorption of iron.
If you have any questions or concerns, consult your doctor.
Key Takeaways
Vaginal bleeding between periods, while common, is not a natural part of the menstrual cycle. Some women may notice light bleeding before expected period. Others may experience heavier flow than usual. In itself, vaginal bleeding between periods is usually harmless. But it is best to always consult your primary physician to clear any serious conditions.
Learn more about Women’s Health here.
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