Patient education: Bleeding between periods (The Basics)

What causes bleeding between periods? — 

Most people get a period about once a month. But a normal cycle can range from 24 days to 38 days.

Sometimes, people notice bleeding between periods. This is sometimes called "intermenstrual bleeding." Light bleeding between periods is also called "spotting."

When a person first gets their period, it's normal to have irregular bleeding. Over time, the cycle usually becomes more regular.

Other things that can cause bleeding between periods include:

●Problems with the uterus, cervix, or vagina (figure 1) – These can include growths (or "polyps"), infection, inflammation, or cancer. Another example is a scar on the uterus from past cesarean birth (c-section).

●Some types of hormonal birth control – These include the pill and the intrauterine device ("IUD").

Sometimes, bleeding happens after sex. Other times, it is unpredictable.

In some cases, people think the blood is coming from their vagina, but it turns out to be blood from their urinary tract or rectum.

Will I need tests? — 

Maybe. Your doctor or nurse might recommend tests based on your age, other symptoms, and situation. They will also do a pelvic exam and ask questions, including when the bleeding happens and how heavy it is.

Common tests include:

●Pregnancy test – This is usually done anytime a person has changes in their periods.

●Tests of your cervix ("Pap test" or "HPV testing")

●Tests for sexually transmitted infections ("STIs")

●Pelvic ultrasound – This uses sound waves to make pictures of the uterus and cervix. It can show if there is a problem with any of these organs.

●Tests on a sample of tissue from the uterus

How is bleeding between periods treated? — 

It depends on what is causing your bleeding. For example:

●If you have a health problem, your doctor will recommend treatment. For example, polyps can often be removed with surgery. Infections, including STIs, might need treatment with antibiotics.

●If your bleeding is related to your birth control, you might choose to switch to a different type.

When should I call the doctor? — 

Call your doctor or nurse if you:

●Have any new bleeding between periods

●Have very heavy periods

●Have other new symptoms, like fever, pain with urination, or unusual vaginal discharge

●Are pregnant or think you could be pregnant

●Have pain and bad cramps in your lower belly before or while you are bleeding

●Have bleeding after you have gone through menopause

More on this topic

Patient education: Menstruation (The Basics)
Patient education: Absent or irregular periods (The Basics)
Patient education: Painful periods (The Basics)
Patient education: Endometrial ablation (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Pregnancy tests (The Basics)
Patient education: Pelvic ultrasound (The Basics)
Patient education: Hysteroscopy (The Basics)

Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Absent or irregular periods (Beyond the Basics)
Patient education: Heavy periods (Beyond the Basics)
Patient education: Painful menstrual periods (dysmenorrhea) (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)