SHARES
Menstruation is a hallmark of womanhood that celebrates the fertility of a woman. However, vaginal bleeding that happen in between menstrual periods can be worrisome. Light spotting should not be a cause for concern. On the other hand, heavy bleeding would warrant a thorough check-up to determine the underlying cause.
The common culprit usually involves hormonal changes or certain medical conditions. In this Part 1 of the article, we will discuss about bleeding between periods due to hormonal contraception or pregnancy-related complications. Then in Part 2, we cover causes due to gynaecological conditions such as sexually transmitted infection (STI), polyps, cancer and endometriosis.
Causes of bleeding between Menstrual Periods
Hormonal Contraceptives
A variety of hormonal contraceptives are available in the market. The contraceptive pill still remains as the most popular contraception method. As the body adjusts to the hormonal changes after starting the pills, spotting can sometimes be observed. This happens especially within the first three months. This irregular bleeding between periods is known as “breakthrough bleeding”. This type of bleeding happens when the increase in progestin thin out the endometrial lining to prevent pregnancy.
In addition, other potential causes of spotting include forgetting to take the pill, incomplete absorption of hormones in the pill due to vomiting or diarrhoea, reduced effectiveness of the pill caused by drug interactions, or implantation bleeding from a pregnancy (due to contraceptive failure).
Nevertheless, one can avoid spotting through medication compliance. For instance, take the pill at the same time every day to ensure consistent hormone level in the body. Besides that, continue to take the pill despite bleeding to allow adjustment to hormonal changes. Also, always check with your doctor or pharmacist about potential drug interactions before starting new medications.
In case bleeding persists up to six months, discuss with your doctor to explore if changing to another type of contraceptive pill may be better.
It is also important to note that emergency contraceptive pill causes breakthrough bleeding that lasts no more than three days. Bleeding that lasts longer or becomes heavier may indicate other health problems that requires further investigation.
Implantation Bleeding
Implantation bleeding happens to 15-25% of pregnant women in the first trimester when the fertilised egg implants in the uterus lining. Bleeding has been reported during one to two weeks after fertilisation which is around the time of missed period. Also it can occur anytime in the first eight weeks of pregnancy.
One may notice light spotting or a consistent flow that requires a liner or light pad to contain. Take note of the colour, consistency and the frequency of bleeding to allow a more accurate diagnosis. In any case, seek medical attention immediately if there is heavy bleeding or clotting, as this could be an early sign of miscarriage.
Miscarriage
Sadly, miscarriages end up to one in five known pregnancies. Reasons leading to miscarriage include abnormal development of the fetus, or poorly controlled diabetes or uterine problem of the mother.
Bleeding due to miscarriage vary from one person to another. Generally, there are more bleeding and tissue loss in a later miscarriage . The bleeding could start as a light spotting or heavy bleeding. As the cervix dilates to empty, the bleeding becomes heavier for three to five hours. In most cases, light spotting will persist for around two weeks before it ceases naturally.
Termination of Pregnancy
Bleeding sometimes follows after an abortion as the body expels tissue from the pregnancy. It may last for one to two weeks before it tapers to light spotting, which may continue for a few more weeks until the next period.
Conclusion
Many reasons could have led to bleeding between periods. Although light spotting that goes away after a few days can be dismissed, heavy bleeding should be given immediate medical attention. If you or your loved ones are concern about bleeding between periods, consult a doctor today.
Further reads: Common Causes of Bleeding Between Periods [Part 2]
Find an Obstetrician & Gynaecologist in Malaysia, on GetDoc
Find an Obstetrician & Gynaecologist in Singapore, on GetDoc
by Joanne Lee
Multipotentialite. Loves creating and seeing ideas come alive. View all articles by Joanne Lee.
