Bleeding Between Periods

Bleeding between periods for women during their childbearing years can be inconvenient and annoying. Most women have spotting (light bleeding), breakthrough bleeding (heavier bleeding), or irregular periods at some point in their lives. Spotting or breakthrough bleeding between periods usually lasts 1 or 2 days.

Vaginal bleeding can indicate serious problems in women who are pregnant, women who have been through menopause (no periods for 1 year or more) and are not using hormone therapy, or girls who have not yet reached puberty. Women or girls in these categories who have vaginal bleeding should see their health care provider.  

Causes

Some women in their childbearing years regularly have spotting around the time of ovulation. Bleeding between periods is also common when hormones are fluctuating (rising and falling) the most -- during the first few years of menstruation and again as women approach menopause.

Spotting is very common in women with intrauterine devices (IUDs). It may also occur if the hormone levels in the birth control pills a woman is taking are not adequate. In most of these cases, spotting is not cause for concern, but your doctor may be able to help end the problem by prescribing a different pill or recommending another form of birth control. Spotting and breakthrough bleeding are also very common with Depo-Provera (a birth control shot), especially during the first 3 months. Also, if you miss a dose of the pill, you may have spotting.

Bleeding between periods also can be a sign of a more serious problem, such as ectopic pregnancy or cancer.

Treatment

Your doctor may recommend an endometrial biopsy to check for cancer and other problems. A dilation and curettage (D & C), in which the uterine lining is gently scraped and cleaned away, may be suggested. For some women, a D & C will end the problem of spotting.

Self-Care for Bleeding Between Periods

It's important to keep a menstrual diary if you begin having bleeding that is unusual for you. This diary can help your doctor or nurse practitioner find the possible cause and decide whether the between-period bleeding is anything to be concerned about. Keep a written record of the dates of your periods and any bleeding between periods. Note how long the bleeding lasted and how heavy the flow was.

Call your doctor if your menstrual pattern does not return to normal by the third month.