Bleeding in between periods: should I be worried?

Bleeding in between periods may cause alarm bells to ring in a woman’s head, but is it always a cause for concern? Distinguished consultant in obstetrics and gynaecology Miss Luxmi Velauthar discusses the principal causes of irregular bleeding and reassures you of any worries you may have.

Having intermittent or continuous bleeding or spotting in between your periods can be due to many reasons. Although some of these reasons may not be serious, it is essential to seek medical help early.

What are the principal causes of irregular bleeding?

Hormonal contraceptives

Irregular periods, including bleeding or spotting between your periods, can be a common side effect when starting hormonal contraception methods such as the combined oral contraceptive pill, progestogen-only contraceptive pill, contraceptive patches (transdermal patch/ es), contraceptive implant, contraceptive injection/s, or the intrauterine system (IUS).

This often occurs during the adjustment period when your body is getting used to the contraception method you are using.

Irregular bleeding or spotting can also occur if you miss any combined pill/s or progestogen-only pill/s and/or are having problems with your contraceptive patch, vaginal ring, or other any other contraception device/s.

If you are on the pill and experience vomiting or diarrhoea shortly after taking your pill, this may cause irregular bleeding or spotting in between your periods.

What are some other causes for irregular vaginal spotting and or bleeding?

Some other causes of bleeding or spotting between your periods may include the following:

Emergency contraceptive pill: Taking the emergency contraceptive pill may lead to irregular bleeding or spotting in between your periods.

Vaginal injury: Injury to the vagina, such as during penetrative sex, may cause bleeding or spotting between your periods.

Recent abortion: Heavy bleeding after a recent abortion may require medical attention.

Sexually transmitted infections (STIs): Some STIs, like chlamydia, can cause bleeding or spotting between your periods. It is advisable to get tested after unprotected sex with any new partner.

Recent miscarriage: Bleeding or spotting can occur after a recent miscarriage.

Hormonal changes: Hormonal fluctuations, particularly in women approaching menopause, can lead to irregular vaginal bleeding or spotting, between periods.

Stress: High levels of stress can contribute to bleeding into periods.

Vaginal dryness: Vaginal dryness can sometimes lead to irritation and vaginal spotting.

Cervical changes: Changes in the cervix (or the neck of your womb), such as cervical ectropion (or when the inner lining of the cervix comes outside) or cervical erosion, (same as ectropion where there is a loss of the outer protective coat of the cervix) can be associated with bleeding or spotting in between your periods.

Cervical Cancer: Irregular vaginal bleeding or spotting may be an indicator of cervical cancer.

Uterine (womb) cancer: Irregular vaginal bleeding or spotting may be a symptom of womb cancer. This type of cancer is more common after the menopause.

Vaginal or vulval cancer: Cancer of the vaginal or vulval area (the outer part of your genitals) may lead to irregular periods.

Cervical or endometrial polyps: Small fleshy lumps inside your cervix or womb lining, are known as polyps, and can occasionally cause irregular periods. Fortunately, they are principally non-cancerous.

Fibroids: Uterine fibroids are lumps in and around the muscles of your womb and/ or the neck of the womb. These may cause abnormal vaginal bleeding patterns. These lumps are predominantly non-cancerous.

If you are experiencing bleeding or spotting in between periods and would like to book a consultation with Miss Velauthar, do not hesitate to do so by visiting her Top Doctors profile today.