Table of Contents
- What is Intermenstrual Bleeding?
- Causes of Intermenstrual Bleeding
- Frequently Asked Questions about Intermenstrual Bleeding
Breakthrough bleeding, also known as bleeding between menstrual periods or metrorrhagia, refers to bleeding that a woman may experience between one menstrual period and the next.
The reasons behind bleeding between periods are diverse, and although in many cases they are of a mild nature and do not indicate an underlying condition, there is also the possibility that they may be associated with more serious problems.
For this reason, it is important for a woman to consult a specialist if she experiences breakthrough bleeding.
What is breakthrough bleeding?
Breakthrough bleeding is bleeding that occurs outside a woman’s regular menstrual cycle. It is vaginal bleeding that occurs between one menstrual period and the next, being outside of the usual menstrual cycle.
This type of bleeding can vary in duration and amount, and can have a variety of causes ranging from hormonal changes to underlying medical conditions.
What are the causes of breakthrough bleeding?
Spotting or breakthrough bleeding at ovulation
Metrorrhagia can have different origins. Generally, bleeding between periods usually occurs because ofovulation.
Many women can tell they are ovulating by changes in their cervical mucus and others by a small amount of brownish or reddish bleeding that usually lasts two to three days.
When ovulation occurs, the follicle containing the egg ruptures, which may bleed, and this bleeding is discharged through the fallopian tubes.
Implantation bleeding
When a woman becomes pregnant, one of the possible causes of breakthrough bleeding is implantation bleeding. Implantation bleeding usually manifests itself as light, brownish or pinkish bleeding and can last from a few hours to 2-3 days.
Bleeding from endometrial polyps
Other causes of bleeding between periods include endometrial polyps. These are formations that usually disappear between periods.
They can cause bleeding before, during and in the days following menstruation. Although various symptoms such as heavy menstruation may indicate their presence, they are diagnosed by ultrasound.
Other causes of breakthrough bleeding
Además de lo anteriormente explicado, hay otras razones por las cuales es posible experimentar sangrado entre los períodos menstruales. Estos incluyen los siguientes:
- Hormonal changes
- Use of hormonal contraceptives
- Changes in the cervix
- Myomas
- Endometriosis
- Endometrial cancer
- Sexually transmitted infections (STIs)
- Pelvic inflammatory diseases (PID)
- Injuries to the cervix or uterus
- Stress
- Fatigue
- Weight changes
- Medication
- Ectopic or extrauterine pregnancy
- Hypothyroidism
The occurrence of breakthrough bleeding depends on the individual woman; some women experience it frequently, while others have never experienced it at all.
If you experience breakthrough bleeding, it is important to see a specialist. The gynaecologist will be able to assess the cause of your bleeding and recommend the most appropriate treatment.
Frequently Asked Questions about breakthrough bleeding
What are the symptoms of breakthrough bleeding?
Symptoms of bleeding between periods may include:
- Bleeding between periods
- Heavy periods
- Pelvic pain
- Pain during intercourse
- Fatigue
- Irritability
- Nausea
- Vomiting
What to do about breakthrough bleeding?
Metrorrhagia bleeding is usually mild. But as we have seen above, it could be a sign of something more serious.
Make an appointment if the spotting worries you, or if you have symptoms in addition to the bleeding, such as:
- Lower abdominal pain.
- Fever.
- Any vaginal bleeding after you have gone through the menopause.
- Bleeding between periods is different from persistent bleeding, so if you have heavy or prolonged bleeding, you should make an appointment for a check-up.
How to prevent bleeding between periods
To prevent breakthrough bleeding, there are a few things you can do. Some options include eating a healthy, balanced diet, avoiding stress and alcohol, and exercising regularly.
Hormonal contraceptives can also be used to regulate the menstrual cycle and reduce breakthrough bleeding.
Is it normal to have breakthrough bleeding while using contraception?
It is common for some women to experience bleeding between periods while using contraception. This can be a temporary side effect, and often disappears over time.
If bleeding persists or is heavy, it is important to consult a doctor to determine whether it is necessary to switch to a different type of contraceptive or if there is an underlying cause that requires treatment.
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Bibliography
- American College of Obstetricians and Gynecologists. (2018). Intermenstrual bleeding. ACOG Practice Bulletin. Obstetrics and Gynecology, 131(5), e139-e147.
- American Family Physician. (2019). Intermenstrual bleeding. American Family Physician, 99(11), 916-922.
- Mayo Clinic. (2023). Menstrual bleeding between periods. Mayo Clinic.
- National Institutes of Health. (2023). Intermenstrual bleeding. National Institutes of Health.
- UpToDate. (2023). Intermenstrual bleeding. UpToDate.
