Bleeding between periods can have a range of causes, including hormonal changes and injury. If the blood flow is light, healthcare professionals may call it ‘spotting.’
Bleeding between periods refers to any bleeding that occurs after the period ends or before the next period is due to begin. When this happens, someone may notice light brown spotting in their underwear or a heavy flow resembling a regular period.
In this article, we look at the possible causes of bleeding between periods, possible ways to prevent spotting, and when to see a doctor.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
The medical term for bleeding between periods is metrorrhagia. It is also known as spotting or breakthrough bleeding.
The menstrual cycle refers to the time between the first day of one period and the first day of the next. The cycle typically lasts around
A period refers to the time when a woman bleeds each month, which usually lasts between 3–5 days but can range anywhere between 1 and 8 days. Periods are different for every person.
There is a variety of reasons for bleeding between periods:
Hormonal contraceptives
Hormonal contraceptives are a common cause of vaginal bleeding between periods. For instance, hormonal intrauterine devices (IUDs) may cause bleeding that improves after 2–6 months of using the contraceptive.
Some examples of hormonal contraceptives include:
- IUD
- birth control patch
- vaginal ring
- contraceptive pill
- contraceptive implant
If bleeding between periods is very heavy, it may be a good idea to seek medical advice. Changing to an alternative form of contraception can often stop breakthrough bleeding.
Bleeding between periods can happen if a person does not take their hormonal contraception according to the instructions. For example, a woman may miss taking a contraceptive pill or have a problem with a birth control patch. This can sometimes cause spotting.
Emergency contraception
Using emergency contraceptive may also cause bleeding. This applies to both forms of emergency contraceptive: the morning-after pill and the IUD.
Implantation bleeding
Some women experience spotting shortly after becoming pregnant, marking the moment when the fertilized egg implants into the lining of the uterus. This is called implantation bleeding. They may also feel a slight cramping in the uterus.
Miscarriage
Bleeding between menstrual periods is one early sign of a miscarriage. Miscarriages can occur at any time within
Termination
Many people experience some bleeding after having a termination or abortion. Spotting may last several weeks after an in-clinic procedure or taking the abortion pill. If bleeding is very heavy, seek medical advice.
Sexually transmitted infections
Some sexually transmitted infections (STIs) can cause vaginal bleeding. Chlamydia is a typical example. As well as spotting between periods, chlamydia can cause bleeding during or after sex.
Injury
If the skin or tissue of the vagina is damaged, it can bleed. The most common way for this to happen is during penetrative sex. It is much more likely if the vagina is dry.
The body produces a natural lubricant that prepares the vagina for penetrative sex. Vaginal dryness can be due to many factors including:
Menopause or perimenopause
Menopause usually begins at around
Perimenopause is the period leading up to menopause. This can last for up to 10 years as hormone levels in the body change.
Hormone levels are often unstable during perimenopause. This can cause irregular periods, spotting, and heavy bleeding.
Polyps in the cervix or vagina
Polyps are small growths. They can develop in the uterus or on the cervix, which is the structure between the vagina and uterus. In some cases, polyps can cause bleeding and a doctor may need to remove them.
Certain cancers
In most cases, bleeding between periods is not a cause for concern. However, vaginal bleeding between periods is one possible symptom of certain types of cancer. Cervical cancer can affect females of any age. It is most common for people ages 40–45.
Bleeding between periods or after sex is a
Uterine or womb cancer is most common in females
Uterine cancer mostly affects people who have reached menopause. This means that they no longer have periods. Any vaginal bleeding after menopause is cause to speak with a doctor.
If someone has not reached menopause, bleeding may happen between periods. Sometimes, bleeding is heavier than usual. Less common symptoms include pain during sex or pain in the abdomen.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a condition that can cause irregular periods, as well as some bleeding between periods. Other symptoms include:
Endometriosis or adenomyosis
Chronic conditions that affect the uterus, such as endometriosis or adenomyosis, can cause bleeding or spotting between periods. These conditions may also cause heavy or painful menstrual periods and cramps between periods.
If vaginal bleeding between periods is heavy or persistent, a person should seek medical advice.
Being aware of any other symptoms related to spotting between periods can help a doctor diagnose an underlying medical issue.
If someone has recently begun taking a hormonal contraceptive, bleeding may settle after 2–6 months. If it does not, see the prescribing doctor. It may be possible to change contraceptive methods to stop this problem.
STIs are contagious and can cause long-term health problems. If someone suspects an STI is causing vaginal bleeding, they should see a healthcare professional for testing and treatment. Most STIs are curable, usually with antibiotics.
Treatment will depend on the underlying cause. Keeping track of bleeding frequency, duration, and amount can help a doctor diagnose the cause.
Cervical cancer testing, known as screening or a pap smear, checks for anything unusual in the tissue of the cervix. The
Small tears and bleeding can be due to damage to dry skin in the vagina. Using an artificial lubricant and ensuring arousal before sex can prevent damage to the vagina during sexual activity.
There is no cure for PCOS, but it is possible to manage the symptoms. Treatment
Vaginal bleeding between periods can cause anxiety or stress. It may also be painful or uncomfortable, depending on the cause.
Anyone experiencing underlying health problems, such as an STI, should seek treatment as soon as possible. In severe cases, an STI
An early cancer diagnosis increases the chance that treatment will be successful and a person will recover.
Below are some common questions about bleeding between periods.
Should someone worry about spotting after a period?
The American College of Obstetricians and Gynecologists considers any spotting between periods abnormal.
However, abnormal bleeding is not always due to a severe health issue and can be due to causes such as hormonal or emergency birth control or menopause.
If someone is worried about bleeding between periods, they should speak with a healthcare professional for a proper diagnosis and treatment.
Does spotting mean pregnancy?
In some cases, spotting after a period can be due to implantation bleeding, when a fertilized egg attaches to the uterus lining. People can speak with a healthcare professional to determine whether pregnancy is the cause of vaginal bleeding.
The most common reasons for vaginal bleeding between periods are hormonal contraceptives or changes relating to menopause.
Regular cervical screening is an essential part of preventive healthcare that can help to find any unusual cells early.
Being aware of any other symptoms and seeking medical advice can help a doctor to diagnose or rule out a possible health problem.