Bleeding Between Periods
Tracee Cornforth
Your period was over just last week and now it's back. Maybe this has been happening regularly the last few months. Maybe it's the first time it has happened to you. Whether it's the first time you have experienced irregular bleeding between periods, or just another month of spotting, metrorrhagia (the medical term for irregular bleeding or spotting between periods) is frustrating and can lead to a lot of worry thinking something is seriously wrong.
What is normal menstruation?
Normal menstrual bleeding lasts about five days, and although it may seem like you are losing a lot more blood, the amount of blood lost during your period is only about two to eight tablespoons. Menstruation occurs on average every 28 days; but, anywhere from 25 to 31 days between periods is considered a normal menstrual cycle.
When should you worry about bleeding?
If you are post-menopausal, or younger than 11 and vaginal bleeding occurs you should consult your physician.
It's important to be sure that bleeding is coming from your vagina and not from your rectum or urine. The best time for your doctor to determine the cause of menstrual problems is when bleeding is not active.
What causes bleeding between periods?
Although the cause of irregular bleeding can vary according to individual health situations, some of the more common causes include:
- Abortion
- Hormonal fluctuations
- Beginning or stopping oral contraceptives or estrogens
- Low thyroid levels
- Stress
- IUDs occasionally cause slight spotting
- Injury to the vagina from insertion of objects, from malignant cancers, or from vaginal infections
- Certain drugs such as anticoagulants
- Vaginal dryness
- GYN procedures such as CONE biopsy or cervical cauterization
If bleeding is heavy, bed rest may be recommended. Keep a record of the number of pads or tampons that you use so that your physician can determine whether bleeding is abnormally heavy. It's best to avoid taking aspirin because it can prolong bleeding. Whenever you experience irregular bleeding from unknown causes it is wise to call your physician for an appointment, as well as when bleeding occurs after menopause or when other symptoms are present.
Should I See My Doctor?
When you visit your physician your medical history will be taken and a pelvic exam will be performed. You should be ready to answer certain questions relating to the timing of your irregular bleeding, as well as the quality of bleeding, and other factors and symptoms. Your physician may also do a Pap smear and/or an endometrial biopsy if he feels it is necessary. Some of the questions your physician is likely to ask include:- How long have you experienced bleeding between periods? Does it happen every month or is this the first time? What day during your menstrual cycle does the bleeding begin? How long does it last?
- Do you experience menstrual cramps when irregular bleeding occurs? How heavy is the bleeding? How may pads or tampons do you need?
- Does anything make bleeding worse? Does anything make it better? Is bleeding worse with increased physical activity? Are you experiencing an increase in stress?
- Do you have any other symptoms such as pelvic pain, increased bruising, difficulty swallowing, pain or burning during urination? Is there blood in your bowel movements or urine?
It's also important to advise your physician if you are pregnant or have had a recent miscarriage or abortion.
If you have had a D&C, your physician should know this as well. Remember to inform your physician about any prescription or over-the-counter medications (including herbal supplements) that you are taking. The type and size of tampons can sometimes be a helpful clue to help your physician to determine the cause of metrorrhagia. Your physician will also ask you how old your were when you started having periods, if you are sexually active, and whether you have experienced bleeding between periods in the past. If you have experienced any injuries, or had medical or surgical treatments, this is also important to tell your physician.
If you are currently using oral contraceptives your physician should be aware of this: bleeding between periods can sometimes be caused by something as simple as not taking birth control pills at the exact same time each day.
Be prepared to answer these questions when you visit your physician. The treatment your physician prescribes will depend, to a large extent, on your answers to his questions, as well as the findings of your pelvic exam and/or other tests he orders.
source:about.com
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