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Bleeding between periods

Have you noticed any bleeding in between your normal periods? How do you know when to see your doctor for advice?

Bleeding in between periods is also known as intermenstrual bleeding or spotting. It can be quite common and doesn't always mean that there is a problem, but you should report any unexpected bleeding to your doctor as there may be an underlying medical issue that requires attention.

Possible causes of intermenstrual bleeding:

  • Fluctuations in hormone levels – fluctuations may be due to factors such as stress, certain medications, thyroid disorders, or conditions like polycystic ovary syndrome (PCOS).

  • As a side effect of hormonal methods of contraception.

  • Ovulation bleeding - some women may experience light spotting or bleeding during ovulation, which typically occurs midway through the menstrual cycle and is considered normal in many cases.

  • Uterine or Cervical Polyps can cause bleeding between periods. Polyps are growths in the uterus or on the cervix and are usually benign but should be evaluated and ideally removed once found.

  • An ectropion – this is an erosion on the surface of the cervix which can cause unexpected bleeding, especially after sex. These can be easily treated with a simple procedure.

  • Inflammation of the endometrium (lining of the uterus) or cervix caused by infections.

  • Uterine fibroids – these are benign tumours;  depending on the size and location these may lead to other symptoms such as pelvic pain and heavy bleeding.

  • Endometrial cancer - rarely, intermenstrual bleeding can be a sign of abnormal changes in the endometrium or endometrial cancer. While less common, these conditions require prompt medical evaluation and treatment.

Most often, intermenstrual bleeding can be easily treated.  The treatment will depend on the cause of the bleeding, but could involve hormonal therapy or a change in contraception, eradicating any infection, or surgery.

Dr Helen Kennedy

Women’s Health Doctor at The Maxwell Practice in Henley-on- Thames

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