What causes spotting between menstrual cycles. How to differentiate between normal and abnormal vaginal bleeding. When should you consult a doctor about intermenstrual bleeding. What are the potential underlying health conditions associated with irregular bleeding.

Common Causes of Bleeding Between Periods

Intermenstrual bleeding, also known as spotting, is a relatively common occurrence among women of reproductive age. While it can be concerning, in many cases it’s not a cause for alarm. Let’s explore some of the most common reasons for bleeding between periods:

Hormonal Birth Control

One of the most frequent causes of spotting is the use of hormonal contraceptives. These can include birth control pills, patches, injections, and intrauterine devices (IUDs). The hormones in these contraceptives can alter your menstrual cycle, sometimes leading to breakthrough bleeding.

Is spotting normal when starting a new birth control method? Yes, it’s particularly common in the first three months of starting a new hormonal contraceptive. Some types of birth control may cause light or irregular periods for as long as you use them. It’s always best to discuss potential side effects with your healthcare provider when starting a new contraceptive method.

Early Pregnancy

Implantation bleeding is another common cause of spotting between periods. This occurs when a fertilized egg attaches itself to the lining of the uterus, typically about 10-14 days after conception. The bleeding is usually light and may be accompanied by mild cramping.

Can you mistake implantation bleeding for a period? While it’s possible, implantation bleeding is typically much lighter than a normal period and lasts only a day or two. If you suspect you might be pregnant, it’s advisable to take a home pregnancy test and schedule an appointment with your doctor for confirmation.

Perimenopause

As women approach menopause, they enter a transitional phase called perimenopause. This period can last up to 10 years before menopause officially begins. During this time, hormone levels fluctuate, often leading to irregular periods and spotting between cycles.

What are the signs of perimenopause? Besides irregular periods and spotting, other common symptoms include hot flashes, night sweats, mood changes, and vaginal dryness. If you’re experiencing these symptoms and are in your 40s or early 50s, you may be entering perimenopause.

Underlying Health Conditions That May Cause Intermenstrual Bleeding

While most cases of spotting are benign, sometimes bleeding between periods can indicate an underlying health issue. Here are some conditions that may cause abnormal vaginal bleeding:

• Uterine fibroids or polyps
• Endometriosis
• Pelvic inflammatory disease (PID)
• Sexually transmitted infections (STIs)
• Cervical or uterine cancer (in rare cases)

These conditions often come with additional symptoms beyond just spotting. For instance, uterine fibroids may cause heavy menstrual bleeding and pelvic pain, while endometriosis is often associated with severe menstrual cramps and pain during intercourse.

Distinguishing Between Normal and Abnormal Vaginal Bleeding

Understanding what constitutes normal and abnormal vaginal bleeding is crucial for maintaining your reproductive health. Normal menstrual bleeding typically occurs every 21 to 35 days and lasts for 2 to 7 days. The flow can vary from light to heavy, and some women may experience mild cramping.

Abnormal vaginal bleeding, on the other hand, can manifest in several ways:

1. Bleeding or spotting between periods
2. Bleeding after sex
3. Heavy bleeding during your period (soaking through a pad or tampon every hour for several consecutive hours)
4. Bleeding for more than 7 days
5. Bleeding after menopause

Is it normal to have occasional spotting between periods? While occasional light spotting can be normal, especially if you’re using hormonal contraceptives, frequent or heavy bleeding between periods warrants medical attention.

When to Seek Medical Attention for Intermenstrual Bleeding

While some instances of spotting are harmless, there are situations where it’s important to consult with a healthcare provider. Here are some guidelines on when to seek medical attention:

Immediate Medical Attention

Seek immediate medical care if you experience:

• Heavy bleeding that soaks through a pad or tampon every hour for several consecutive hours
• Severe abdominal or pelvic pain
• Dizziness, lightheadedness, or fainting
• Fever accompanied by vaginal bleeding

Schedule an Appointment

Make an appointment with your healthcare provider if you notice:

• Bleeding between periods that becomes more frequent or heavier over time
• Spotting that lasts for more than a few days
• Bleeding after sexual intercourse
• Any vaginal bleeding after menopause
• Bleeding accompanied by unexplained weight loss or fatigue

Should you track your bleeding patterns? Absolutely. Keeping a record of your menstrual cycles, including any spotting or unusual bleeding, can provide valuable information to your healthcare provider if you need to seek medical attention.

Diagnostic Procedures for Abnormal Vaginal Bleeding

When you consult a healthcare provider about abnormal vaginal bleeding, they may perform several diagnostic procedures to determine the underlying cause. These may include:

Physical Examination

A pelvic exam allows the doctor to check for any visible abnormalities in your reproductive organs.

Blood Tests

Blood tests can check hormone levels, assess thyroid function, and rule out certain blood disorders that could cause abnormal bleeding.

Imaging Tests

Ultrasound, CT scans, or MRI may be used to visualize your reproductive organs and check for any structural abnormalities.

Endometrial Biopsy

In this procedure, a small sample of tissue is taken from the lining of the uterus (endometrium) for microscopic examination.

Hysteroscopy

This procedure allows the doctor to look inside your uterus using a thin, lighted tube inserted through the cervix.

How long does it typically take to diagnose the cause of abnormal bleeding? The time frame can vary depending on the complexity of your case and the number of tests required. In some cases, a diagnosis can be made after a single visit, while in others, it may take several appointments and multiple tests.

Treatment Options for Intermenstrual Bleeding

The treatment for bleeding between periods depends on the underlying cause. Here are some common treatment options:

Hormonal Treatments

If the bleeding is due to hormonal imbalances or conditions like PCOS, hormonal treatments such as birth control pills or progesterone therapy may be prescribed.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce heavy bleeding and alleviate pain. Tranexamic acid is another medication that can help control heavy bleeding.

Surgical Procedures

For conditions like fibroids or polyps, surgical removal may be necessary. Procedures can range from minimally invasive options like hysteroscopy to more extensive surgeries in severe cases.

Lifestyle Changes

In some cases, lifestyle modifications such as stress reduction, dietary changes, or weight management can help regulate menstrual cycles and reduce abnormal bleeding.

Can intermenstrual bleeding be prevented? While not all causes of bleeding between periods are preventable, maintaining a healthy lifestyle, managing stress, and staying up-to-date with regular gynecological check-ups can help reduce the risk of some underlying conditions that cause abnormal bleeding.

Impact of Intermenstrual Bleeding on Quality of Life

Bleeding between periods can have a significant impact on a woman’s quality of life. It can cause:

• Anxiety and stress about potential health issues
• Disruption to daily activities and social life
• Discomfort and inconvenience
• Potential embarrassment or self-consciousness
• Interference with sexual activity

How can women cope with the emotional impact of abnormal bleeding? Open communication with healthcare providers, joining support groups, and practicing self-care can all be helpful strategies. Remember that many causes of intermenstrual bleeding are treatable, and seeking timely medical attention can often resolve the issue and alleviate associated stress.

Understanding the potential causes and implications of bleeding between periods empowers women to take control of their reproductive health. While it can be concerning, in many cases, intermenstrual bleeding is not a sign of a serious condition. However, it’s always best to consult with a healthcare provider to determine the underlying cause and receive appropriate treatment if necessary. Regular gynecological check-ups and open communication with your doctor are key to maintaining optimal reproductive health.

Is it Cause for Alarm?: OB/GYN Specialists: OB/GYNs

Most women experience bleeding between periods at some point. It’s usually light bleeding that doesn’t require a tampon or pad, and it’s also called spotting.

You might notice spotting in the middle of your cycle, either in your underwear or while using the restroom. Many different factors — from hormonal birth control to early pregnancy — can trigger spotting, and most of the time, it’s not cause for alarm. But if you notice heavy bleeding, or symptoms like pelvic pain, it could indicate an underlying gynecologic condition. 

At OB/GYN Specialists, Daniel McDonald, MD, Marc Wilson, MD, and our team specialize in gynecologic care for women of all ages. If you’re concerned about bleeding between periods, call us at 940-202-0566 to make an appointment.

What causes spotting?

A woman’s menstrual cycle is typically 21-35 days long. The first day of a new cycle is the first day of your period, and the average period is 2-7 days long. Most of the time, you won’t notice vaginal bleeding in the middle of your cycle, but certain factors can cause spotting.

Hormonal birth control

Using hormonal birth control is one of the most common causes of bleeding between periods. Many types of hormonal birth control, including pills, patches, injections, and intrauterine devices (IUDs), release hormones to prevent pregnancy, and they can alter your menstrual cycle.

Breakthrough bleeding between periods is particularly common in the first three months of starting a new method of hormonal birth control. Some types of birth control may make periods light or irregular as long as you use them, so talk to your doctor about what you can expect.

Early pregnancy

Another common cause of spotting between periods is early pregnancy. It can take up to two weeks after conception for the fertilized egg to implant itself in your uterus. When implantation occurs, light bleeding and cramping are common symptoms.

If you think you might be pregnant, take an at-home pregnancy test and schedule an appointment with your doctor.

Perimenopause

Perimenopause is the transitional period before menopause. Menopause starts when you haven’t had a menstrual period for one full year, but symptoms can start up to 10 years before you reach menopause. 

Perimenopause is characterized by dropping hormone levels, and it can make your periods harder to predict. Irregular periods and spotting between periods are common symptoms for women in perimenopause.

Underlying health conditions

In some cases, bleeding between periods could be caused by an underlying health issue, like:

Abnormal bleeding between periods, especially if it’s accompanied by pelvic pain or fever, should be evaluated by your doctor.

When to see the doctor for bleeding between periods 

Never hesitate to make an appointment with your doctor if you’re worried about bleeding between periods. Dr. McDonald and Dr. Wilson provide comprehensive exams to diagnose potential causes of spotting, so we can recommend an appropriate treatment plan.

Light bleeding between periods typically isn’t an indication of something more serious, but it’s important to recognize signs that something isn’t right. Make an appointment with your gynecologist if you have spotting along with lower abdominal pain, pelvic pain, or fever.

If bleeding between periods gets worse or starts happening more often, it could indicate an underlying health condition. If you experience bleeding between periods that isn’t light or doesn’t stop within a few days, make an appointment with your doctor.

After you’ve entered menopause, see the doctor if you experience vaginal bleeding at any point. Even if it’s light bleeding, bleeding after menopause could be a sign of cancer or other serious health condition.

Listening to your body is important. If you’re concerned about spotting or bleeding between periods, schedule a check-up at OB/GYN Specialists. Call our team at 940-202-0566 or send us a message online.

Vaginal bleeding – Mayo Clinic

Abnormal vaginal bleeding is any vaginal bleeding unrelated to your period. This type of bleeding may include spotting of small amounts of blood between periods — often seen on toilet tissue after wiping — or extremely heavy periods in which you soak a pad or tampon every one to two hours for two or more hours.

Vaginal bleeding during your period (menstruation) occurs every 21 to 35 days when the uterus sheds its lining, marking the start of a new reproductive cycle.

Menstrual periods may last for just a few days or up to a week. Bleeding may may be heavy or light. Menstrual cycles tend to be longer for teens and for women nearing menopause. Menstrual flow may also be heavier at those ages.

June 15, 2021

Show references

1. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 128. Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstetrics and Gynecology. 2012;120:197.
2. Kaunitz AM. Approach to abnormal uterine bleeding in nonpregnant reproductive-age women. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
3. Kaunitz AM. Differential diagnosis of genital tract bleeding in women. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
4. Zacur HA. Managing an episode of severe or prolonged uterine bleeding. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
5. AskMayoExpert. Abnormal uterine bleeding: Premenopausal women (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
6. AskMayoExpert. Postmenopausal bleeding. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
7. Kliegman RM, et al. Gynecologic history and physical examination. In: Nelson Textbook of Pediatrics. 21st ed. Philadelphia, Pa. : Elsevier; 2020. http://www.clinicalkey.com. Accessed April 18, 2019.
8. Your menstrual cycle. Womenshealth.gov. https://www.womenshealth.gov/menstrual-cycle/your-menstrual-cycle. Accessed April 18, 2019.
9. Goodman A. Postmenopausal uterine bleeding. https://www.uptodate.com/contents/search. Accessed April 17, 2019.
10. Gonorrhea — CDC fact sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm. Accessed April 18, 2019.
11. Frequently asked questions. Pregnancy FAQ090. Early pregnancy loss. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Early-Pregnancy-Loss. Accessed April 18, 2019.
12. Walls RM, et al., eds. Vaginal bleeding. In: Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed April 18, 2019.
13. Fritz MA, et al., eds. Abnormal uterine bleeding. In: Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://www.ovid.com/site/index.jsp. Accessed March 7, 2016.
14. Fritz MA, et al., eds. Oral contraception. In: Clinical Gynecologic Endocrinology and Infertility. 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2011. http://www.ovid.com/site/index.jsp. Accessed March 7, 2016.

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What causes spotting between periods? – Blog

Medically reviewed by Rosanna Sutherby on December 3, 2019. Written by Jordana White. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Any time you have abnormal vaginal bleeding, it can be frightening. You want to know why it’s happening and what it can mean for your overall health. There are many reasons why you might be spotting outside of your menstrual cycle. Some are harmless, but some could be a sign of a serious health problem. That’s why it’s important to determine the cause of spotting, or intermenstrual bleeding [1].

Often, spotting between your menstrual cycle happens as a result of implantation bleeding [2]. If you’re wondering when implantation bleeding occurs, how long implantation bleeding lasts, and what implantation spotting looks like, read more below.

Common causes

Spotting between periods can happen for a variety of reasons. Some spotting causes will be relatively easy to treat, while others may require more serious intervention.

Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs) like chlamydia can cause bleeding between periods [3]. If left untreated, chlamydia can lead to serious complications. A convenient way to test is with the Everlywell Chlamydia & Gonorrhea Test.

If you’re having unprotected sex and believe that you may have been exposed to an STI or are experiencing irregular menstrual cycle issues and spotting, the Everlywell at-home STD Test for women is an easy way to check for six common STIs.

Birth control

If you use hormonal birth control, like birth control pills or an IUD (intrauterine device), spotting is common in the first three months [4]. Known as breakthrough bleeding, this spotting occurs as your body’s new hormone balance changes your uterine lining. You should mention the bleeding to your healthcare provider, but it will likely disappear once your body adjusts to the new birth control.

Implantation bleeding

In the early days of pregnancy, you may experience implantation bleeding (spotting associated with an embryo implanting in your uterus.) This kind of spotting doesn’t look like a period.  It may be light—you’ll notice a bit of blood as you wipe—but your implantation bleeding may also have a light, consistent flow. You may even need to wear a liner or pad. Sometimes, implantation bleeding may mix with cervical mucus. It may be red (light or dark), orange, pink, or even brown. Implantation bleeding typically doesn’t last long—it should stop after a few days.

Not every pregnant woman will experience implantation bleeding, but if you do, it will usually occur 10 to 14 days after conception (about the time you’d notice a missed period.) Sometimes, implantation bleeding shows up later in your pregnancy. It is considered normal up to the eighth week of pregnancy. Still, if you may be pregnant and you notice spotting, record the frequency and approximate volume. See your healthcare provider to discuss as well.

Pregnancy complications

Sometimes, abnormal vaginal bleeding can be a sign of problems with your pregnancy [5]. If you have an ectopic pregnancy—where the embryo implants in your fallopian tubes instead of your uterus—you will likely experience vaginal bleeding. Vaginal bleeding when you’re pregnant can also be a sign of miscarriage. See your healthcare provider any time you notice bleeding during pregnancy.

Though less common, other health conditions may cause you to bleed between your periods.

• Fibroids: these are muscular tumors that grow in or on your uterus. Though not cancerous, they can cause you to experience long, heavy periods, and bleeding outside your menstrual cycle [6].
• Polycystic ovary syndrome (PCOS): with this condition, your ovaries don’t release eggs on time, causing them to become enlarged. If you have PCOS, you may lose your period, have irregular periods, or notice bleeding between periods [7].
• Cancer: cancers of your uterus, vagina, ovaries and cervix can all present with spotting between periods [8].

Seeking medical care

Any time you have abnormal vaginal bleeding, you should talk to your healthcare provider, especially if you’re pregnant or have already been through menopause. If you’re spotting and experience other symptoms, you may need emergency medical care. These symptoms may include:

• Dizziness
• Pain, especially in your lower abdomen
• Fever
• Extreme fatigue

Common questions

How do I know if I’m spotting or it’s my period?

Your period isn’t always regular, so it can sometimes be hard to differentiate between an early period and bleeding outside of your period. With spotting, unlike your period, you usually produce less blood than your period. And the color of your blood is usually lighter with spotting than with your period.

How do I know if I am experiencing abnormal vaginal bleeding?

While many women, especially adolescents, have irregular periods, it’s still important to be aware of what your normal menstrual cycle looks like and what symptoms you have regularly. If your periods suddenly become less frequent, heavier, or you experience spotting, it’s important to speak with a healthcare provider. Tracking your menstrual cycle each month helps you stay aware of any potential changes in your health.

Abnormal Vagina Bleeding & Birth Control

Abnormal vaginal bleeding & birth control at a glance:

• Vaginal bleeding that is considered abnormal occurs when a woman is not expecting her menstrual period, when the flow is lighter or heavier than normal, or when spotting occurs between periods.
• Sometimes birth control pills, patches, injections, rings and implants can cause spotting between periods or abnormal vaginal bleeding.
• In other situations, these hormone-based birth control methods are used to treat abnormal vaginal bleeding that result from other medical conditions.
• Women who experience abnormal vaginal bleeding should consult their physician, as it can signal a serious underlying disorder.

When birth control causes abnormal vaginal bleeding

Birth control pills, patches, implants, injections and rings that contain hormones can cause abnormal vaginal bleeding as a side effect. This can occur:

• During the first few months when a woman begins using hormone-based birth control.
• When changing the type of birth control pill or the dose of estrogen.
• When a woman does not take her birth control pill correctly, missing doses or not taking them at the same time each day.
• After using birth control for a long time, which can affect the lining of the uterus and cause bleeding.
• During the first few days of using an intrauterine device (IUD), one either with or without the synthetic hormone progestin; some women continue to experience spotting between periods with an IUD.
• When using the Depo-Provera birth control injection.
• When using a birth control implant.

It is important to check with a health care provider to determine the cause of abnormal vaginal bleeding. It may be due to one of the birth control issues above, which should be monitored.

Using birth control to treat abnormal vaginal bleeding

Abnormal vaginal bleeding may be caused by more serious factors, such as polycystic ovary syndrome, endometriosis, pelvic organ infections or certain cancers. Birth control pills, patches, implants, injections or rings that contain a combination of the hormones estrogen and a synthetic form of progesterone may be used to treat the abnormal vaginal bleeding caused by these conditions. These low doses of hormones regulate the menstrual cycle, reducing or eliminating the abnormal bleeding.

Can I use birth control pills if I have abnormal vaginal bleeding?

Check with your doctor first. Report any bleeding that occurs while taking birth control pills then follow your health care provider’s advice. In many instances, it is normal to continue with your current method of birth control.

When to see a doctor

It is important to see a physician for medical advice if abnormal vaginal bleeding increases or becomes severe. Other signs that medical attention is needed include:

• Pain in the lower abdomen
• Unusually heavy bleeding
• Fever
• Increase in the frequency or severity of symptoms

Get Treatment

What It Could Mean When You Bleed In Between Your Period

Caught some blood in your underwear, but you’re still two weeks away from your period? Don’t panic, this can be normal. Light bleeding in the middle of your cycle or outside of your menstrual period, also known as ‘spotting’ or ‘breakthrough bleeding’, can happen for a variety of reasons. These can range from simple hormonal changes to injury to a deeper underlying issue. Spotting *typically* doesn’t last for more than a few days, but that’s still annoying enough when you have to deal with bleeding for ¼ of the month already.

It’s important to monitor your normal cycle from month to month so you can be aware of any changes that may affect your body. Our body is a sacred temple; let’s not forget that! Changes in your lifestyle can have a big impact on the way your body functions; for example, people who smoke are at a higher risk of experiencing spotting.

Where Does It Come From?

Breakthrough bleeding or spotting can come from either your upper or lower reproductive tract, i.e. your uterus or cervix/vagina. This bleeding is different from that which occurs during your period, which is a result of the inner walls of your uterus lining being shed.

Causes

A lot of the time the cause of the irregular bleeding isn’t found, and generally goes away after one occurrence. For others, this can be a prolonged issue that may need further attention from a medical professional. We’ve outlined a few common causes for you to consider that may assist in determining where the bleeding is coming from.

Ovulation

A day or two after ovulation some women can notice light spotting, which can be a regular occurrence for certain people. Be mindful not to confuse this with menstruation, as ovulation is the time when you are most fertile and could lead to some unexpected pregnancies if you’re not careful!

Pregnancy

Spotting can occur during the first few months of pregnancy and is a common symptom of early pregnancy. There is no need to be alarmed unless the bleeding is quite heavy, then it is best to contact your healthcare professional. Spotting during pregnancy can also be a symptom of an ectopic pregnancy, which occurs somewhere other than the uterus.

Miscarriage

A miscarriage can happen at any stage of a pregnancy, and may even happen before the person is aware that they are pregnant. Miscarriages happen in the first 20 weeks of pregnancy, when the fetus dies in the womb and can be a shock to the system. Breakthrough bleeding associated with miscarriage can last for two weeks or more, so check in with your doctor at the first signs of a potential miscarriage.

Hormonal Contraception

If you’ve just switched to a new contraceptive, or have just started taking one – whether it be the pill, the patch, the implant or the intrauterine device (IUD) – you may find yourself experiencing irregular bleeding within the first three months. Also, if you’re skipping the directions and not taking your contraception according to the instructions you may find yourself experiencing in-between menstruation bleeding. If the spotting you’re experiencing from new contraception lasts longer than three months, or is extremely heavy check-in with your doctor, or ask about changing to an alternate form of contraception.

Sexually Transmitted Infections (STIs)

Certain sexually transmitted diseases, such as chlamydia or gonorrhoea, can cause spotting as well as bleeding during or after sex.  These diseases can be passed from one person to another easily through unprotected sex and can cause infertility if left untreated. So if you think you may have contracted an STI consult your doctor immediately for treatment.

Sex

If you catch yourself having sex that isn’t lubricated enough, or maybe just a little too rough, it can cause damage to the tissue of the vagina, which may result in bleeding. Vaginal dryness may happen for a variety of reasons that aren’t just limited to not being turned-on. Changing hormone levels as a result of medication or illness can cause you to be dry as well, so don’t feel shy to reach out and get some lube if necessary!

Pre-Menopause

During the period leading up to menopause, known as perimenopause, the body can experience fluctuating hormone levels. Hormone levels in the body alter for sometimes up to 10 years before menopause, which can often cause irregular bleeding and spotting.

Prevention & Management Tips

For pain relief associated with pull out your Livia, lay back and let her do her magic. Using a light panty liner will put your mind at ease and let you continue with your daily activities without the stress of wondering if you’re bleeding through your clothes. Depending on what is causing the bleeding you may or may not be able to prevent the bleeding between your periods, but it is best to have a proper diagnosis if the bleeding continues.

Treatment & Diagnosis

To assist with proper diagnosis keep a record of the bleeding, noting the frequency and duration. Treatment varies depending on the source of the bleeding, and could be something as simple as changing your contraception to jumping on a dose of antibiotics.

When Should You See A Doctor?

Breakthrough bleeding or spotting can be very normal, and isn’t an immediate cause for panic. However, if the bleeding is ongoing or very heavy make sure to check in with a doctor to confirm that there aren’t any serious underlying issues. For women who are going through menopause and are experiencing spotting or irregular bleeding, tell your doctor straight away, as this could be a symptom of an infection or hypothyroidism, a deficiency in thyroid hormones.

Abnormal Bleeding For Women

Unexpected Bleeding or Spotting? Make an Appointment with Your OB-GYN Today.

Every woman has been there, simply experiencing some unexpected bleeding or perhaps miscalculating your monthly menstruation cycle. The reality is that spotting and breakthrough bleeding is extremely common. Many factors can cause you to bleed-off cycle, and most of them are not a cause for concern. For example, spotting can be related to early pregnancy or birth control pills.

An unexpected trickle of blood could mean new life or an end to this month’s fertility —either way, it’s important to react immediately. Contact Gwinnett, the best obstetricians in Snellville. In some cases, breakthrough bleeding may be a sign of a medical issue that requires evaluation and treatment. If you are seeing bleeding between periods and aren’t sure why — especially if accompanied by pain or other symptoms — get in touch with your OB-GYN. At Gwinnett OB-GYN you can make an appointment online or call our Snellville, GA office at (770) 972 – 0330.

Bleeding or spotting is not usually a cause for concern. Normal vaginal bleeding, also known as your period, can happen for a few days to a week. A period usually lasts between 2 and 7 days and occurs monthly. However, periods are different for every woman. A woman’s menstrual cycle continues between the first day of one period and the first day of the next. This cycle typically lasts between 25 and 30 days but can be longer or shorter. Any bleeding outside of this is considered abnormal and can be caused by a variety of factors.

Top Things to Know

• Spotting is any bleeding that occurs outside of your menstrual period.
• Light bleeding at the beginning or end of your period is not spotting.
• Spotting can be a side effect of your hormonal contraceptive.
• Any unexplained spotting should be addressed with your healthcare provider.

Periods Are Different For Every Woman

Rest assured experiencing bleeding or spotting between periods is usually not a cause for concern. Your menstrual cycle is vital to be aware of, but don’t fret if irregular bleeding or spotting occurs. In most cases, there is no cause for concern if vaginal bleeding happens between periods.

Vaginal bleeding between periods is usually not a cause for concern. Spotting is when the blood flow is light. If the blood flow is light and creates spots rather than a heavy flow, it is called ‘spotting.’  When this happens, it is common for a person may notice light brown spotting. Bleeding between periods refers to bleeding occurring after your period ends, or before your next period begins. Spotting is very different from persistent bleeding. If you’re experiencing persistent, heavy, or prolonged bleeding make an appointment to get it checked out and find out why Gwinnett OB/GYN is the best in Snellville.

Possible Factors for Abnormal Bleeding

Bleeding between periods or abnormal bleeding can be caused by a range of factors, including hormonal changes, injury, or an underlying health condition. Irregular bleeding between periods is also called intermenstrual bleeding, spotting, or metrorrhagia. When bleeding occurs between regular periods, there are many possible causes.

Common reasons for spotting between periods include:

1. Hormonal Imbalance Hormone-based birth control can affect your hormone balance and cause hormonal changes that cause spotting. When starting any hormonal contraceptive, abnormal bleeding is common during the first three months. Progesterone and estrogen are the two hormones that regulate your cycle. You may have spotted if they get out of balance from starting or stopping hormone-based birth control. These hormone-based contraceptives include:
   • Birth control pills
   • Intrauterine device
   • Contraceptive patch
   • Contraceptive implant or injection

2. Early Pregnancy Many women experience spotting in the early weeks, also known as the first trimester, of pregnancy. This is called implantation bleeding, which causes spotting during pregnancy. It occurs during the first trimester when a fertilized egg attaches to the wall of the uterus, known as implantation. This light implantation bleeding can be mistaken for a menstrual period and therefore not realize she is pregnant. You can learn more about this on our article about prenatal prevention month.
3. Infections or Physical Conditions Infections, including sexually transmitted diseases (STDs), can be another possible cause of spotting or breakthrough bleeding in between periods. Some sexually transmitted infections (STIs), like chlamydia. Another factor may be physical conditions such as fibroids or polyps. They are non-cancerous tumors that grow in the lining or muscle of the uterus, which can cause spotting. Uterine fibroids are non-cancerous growths that form in the uterus, typically in women who have already given birth.
4. Perimenopause For women over 40 years of age, as you get closer to menopause, your periods might be harder to predict. The lining of your uterus gets thicker, and your hormone level changes. This can sometimes lead to spotting.

When to Call Your OB/GYN

Make an appointment with one of the gynecologists if spotting concerns you, or if you have spots along with the following symptoms:

• Pain in your lower abdomen
• Fever
• Symptoms that continue to get worse or happen more often
• Any vaginal bleeding — including spotting — after you’ve gone through menopause

Spotting Between Periods: 4 Reasons it Happens

Every once in a while, your period may make an unexpected appearance right in the middle of your menstrual cycle. With one drop here or two drops there, spotting between periods can take you by surprise. Should you be concerned?

Some women notice
light spotting for a day
or two after ovulation.

4 Explanations for Spotting Between Periods

1. Ovulation:

   Some women notice light spotting for a day or two after ovulation. This happens regularly for some people. Ovulation is the time in your cycle when you are most fertile. If you are avoiding pregnancy, make sure not to get ovulation spotting confused with menstrual bleeding!

2. Contraception:

   Spotting between periods is a common side effect of hormonal birth control, like birth control pills, hormonal IUDS and patches, shots and implants. Spotting may occur when you start the contraceptive or shortly after stopping its use. If you experience “break through bleeding” every month, let your doctor know. That may not be the right birth control option for you.

3. Pregnancy:

   Many women experience spotting during pregnancy. It usually happens in the first few months. This can be harmless in a healthy pregnancy. If you are experiencing other symptoms of pregnancy, take a test to confirm you are. If you are pregnant, see a doctor right away. A doctor can help you get on the right track for pregnancy and make sure that your spotting isn’t caused by an ectopic pregnancy, which can be life-threatening if left untreated.

4. Menopause:

   As your body prepares to transition out of your child-bearing years, you may experience hormonal imbalances that cause spotting. This is a sign that you are starting the transition to menopause.

Should You Tell Your Doctor?

Yes! While spotting can happen regularly for some women, it can also be a sign of a larger problem. There are many serious conditions associated with spotting. Here are just a few: miscarriage, ectopic pregnancy, thyroid issues, cancer, uterine fibroids or polyps, ovarian cysts or cervical or uterine cancer and many more.

Let your doctor know if you are experiencing bleeding or spotting between periods so that he or she can help you explain the cause or catch a more serious condition as early as possible.

What’s Best to Wear in Case of Spotting?

For light protection on spotty days, try ALWAYS Incredibly Thin Liners. They’re so light and thin, you’ll forget one’s there, yet you’ll feel confident knowing you’re covered.

90,000 Covid vaccine and menstrual cycle: strange side effect?

• Olga Robinson and Rachel Schraer
• BBC Reality Check

May 17, 2021

Photo author, Getty Images

When you come to get the coronavirus vaccine, you will most likely be warned about possible side effects: high fever, headache, or pain in the arm. All this should pass in a day or two. But there is nothing in the leaflets so far that women may also have a change in their menstrual cycle.

At the same time, women around the world began to question: Could premature, severe or overly painful periods be the result of vaccinations.

When Professor Keith Clancy of the University of the American State of Illinois tweeted that she had unusually bad periods following the Moderna vaccine, she immediately received dozens of responses. The women confirmed that they had similar experiences. As a result, Clancy, along with fellow scientist Catherine Lee, launched a questionnaire in which she asked participants to share their observations.

We do not yet know if the vaccine is causing these changes, as the issue has not been specifically studied. It is possible that after vaccination, women simply watched their bodies more closely than usual. Or they might have attributed the change to the vaccine by learning about the experiences of others.

However, according to Dr. Victoria Meil, an expert in reproductive immunology at Imperial College London, some women who have already had menopause, as well as those taking hormonal drugs that stop their periods, have reported bleeding.Therefore, Dr. Meil ​​suspects that some kind of physical reaction is still occurring.

Although this link has not been proven, it could logically be assumed that the vaccine changes the menstrual cycle. At the same time, there is no reason for concern, experts emphasize. While periods can be unexpected and hard, they said, it is not indicative of long-term health risks.

Influence on periods is “very likely”

The inner lining of the uterus (endometrium) is part of the immune system.Immune cells, found in almost all parts of the body, play an important role in the formation of the endometrium, maintaining its function and destruction. Each month it thickens in preparation for pregnancy, and if the egg has not been fertilized, the unsuitable layer of mucous membrane is rejected. It is he who comes out with blood in the form of menstruation.

After vaccination, numerous chemical signals circulate throughout the body that can potentially affect the functioning of immune cells. They, in particular, can cause earlier endometrial detachment, and with it – unexpected signs of menstruation, explains Dr.Victoria Meil.

The link between vaccinations and changes in the menstrual cycle is highly likely, agrees Alexandra Auverne, a scientist at the University of Oxford. According to her, the period of ovulation (the release of an egg towards a potential sperm) can change due to inflammation in the body – when, for example, a person has a temperature. But vaccines can also trigger a similar response in the body: the immune system becomes alert and begins to produce antibodies and other cells to fight the disease.

Earlier research has shown how inflammation caused by infection leads to more painful periods.

There is no connection with miscarriage

But these phenomena are not associated with the risk of miscarriage, Victoria Mail emphasizes. During pregnancy, other processes occur in the uterine lining, in particular, with the participation of the placenta, which connects the fetus to the mother.

According to Dr. Meil, numerous data show that pregnant women did not become more at risk of miscarriage after being vaccinated.

Photo author, Getty Images

Photo caption,

According to reports, the Covid-19 vaccine does not increase the risk of miscarriage, unlike the disease itself

But other studies show that infectious diseases, including Covid-19, do increase the risk of losing a baby or giving birth prematurely, notes Alexandra Auverne of the University of Oxford.

All effects are temporary

Influenza and human papillomavirus (HPV) vaccines are known to have a temporary side effect, such as a shift in the menstrual cycle, but not long-term.

In addition, according to Victoria Mail, there is ample evidence that this does not affect fertility in any way.

However, while there is no cause for concern, Dr. Meil ​​and other scientists we interviewed say more research is needed on the effects of vaccination on the menstrual cycle so that people can know what to expect or fear.

“The problem here is that women’s health issues are often overlooked,” says Meil.

“Imagine they didn’t tell you that fever can be a side effect of vaccinations,” gynecologist Jen Gunter wrote on her educational website. – Surely in this case, you will begin to worry and bewildered, although only you have the usual post-vaccination fever. This is the case with menstrual changes. “

Similar is the situation for postmenopausal women and transgender men who take menstrual control drugs, and unexpected bleeding can cause serious anxiety as a potential cancer symptom.Therefore, it is also important for them to know that after vaccination, such a harmless side effect is possible if the link between vaccination and menstruation is scientifically confirmed, explains US scientist Catherine Lee.

But anyone noticing unusual bleeding should consider seeing a doctor, says Susan Ward, vice president of Britain’s Royal College of Obstetricians and Gynecologists.

Misinformation about vaccines

Meanwhile, the idea that vaccines can interfere with the course of menstruation was picked up by myths spreading people on social networks.

Anti-vaccine groups and conspiracy theorists began to present the true stories of women as proof that vaccines are harmful and part of a global elite plan to sterile the world.

Over the past few weeks, posts have been actively circulating on social networks and causing a stir that a woman’s menstrual cycle can change from just being near vaccinated.

Photo author, Getty Images

Photo caption,

Vaccination opponents believe that the world’s elites want to sterile the world

In one such video, which has received hundreds of thousands of views since mid-April, a “reproductive health practitioner” warns viewers that “women’s menstrual cycles undergo major changes even if they themselves have not been vaccinated.”

Other vaccine deniers and adherents of holistic medicine in equally popular social media posts argued that protein spikes can be transmitted from vaccinated people to others. This is physically impossible.

Most of the Covid-19 vaccines “instruct” the body to create a small fragment of the spike of the virus so that the body can learn to fight it. The spike protein is then decomposed or destroyed. The very mechanism for transmitting instructions – messenger RNA – is also very fragile. This is why vaccines are so difficult to store and transport.

None of the vaccines allow parts of the virus to replicate, let alone pass on to others. The only thing that replicates is your immune cells, which make antibodies to fight the virus.

Pink discharge – reasons for the appearance

Number of views: 384 145

Date of last update: 08/25/2021

Average reading time: 4 minutes

Physiological reasons for the appearance of pink discharge
Pathological causes

Vaginal discharge is usually referred to as a variant of the norm, if it is not very abundant, does not smell (a slight sour smell is allowed) and is not accompanied by pathological manifestations.The mucus moisturizes the vaginal walls, prevents the spread of infection and maintains an optimal microflora. But if a woman develops pink vaginal discharge, this may indicate the development of certain diseases.

Physiological causes of pink discharge

Ovulation . In some women, during ovulation, the vaginal discharge may have small streaks of blood, which makes it appear pink. This occurs as a result of the rupture of the follicle and the release of the egg from the ovary.Sometimes ovulation is accompanied by mild lingering pain in the abdomen.

Taking hormonal drugs . Hormones used for contraception and medical conditions can cause pinkish vaginal discharge. This requires additional specialist advice and examination. Also, pink vaginal discharge often occurs with emergency hormonal contraception.

End of menstruation .At the end of menstrual bleeding, vaginal discharge may turn pinkish or even brown. This usually lasts only a few days and is not accompanied by any other complaints.

Sexual contact . With minor damage to the vaginal mucosa during active intimate relationships or in the case of the first proximity, blood may appear in the vaginal secretion.

Pathological causes

Uterine fibroids . With a violation of the hormonal activity of the ovaries and a high content of estrogen, myomatous nodes grow.They lead to a change in the menstrual cycle, lengthening of menstruation with the release of blood clots and the appearance of acyclic bleeding. Also, with fibroids, mucous discharge from the vagina can acquire a pink or brown tint.

Endometriosis . With this disease, there is a pathological proliferation of the endometrium outside the uterus. The main symptom of the disease is chronic pelvic pain. At the same time, menstruation is very painful. Often, vaginal discharge with endometriosis turns pink.

Cervical erosion . Erosive processes in the cervical canal often occur without obvious symptoms. A woman can suspect the presence of erosion by the appearance of pink discharge after intimate contact. They can also indicate damage to the inflamed cervix.

Endometritis . The disease is accompanied by inflammation of the endometrium – the muscular layer of the uterus. It can be triggered by diagnostic curettage, infectious diseases, etc.The chronic course of the disease may be accompanied by serous-purulent or pink discharge with a small amount of blood streaks.

Endometrial hyperplasia . It is accompanied by excess tissue growth, profuse menstruation, intermenstrual bleeding, at the end of which pink discharge from the vagina often appears.

Polyps . They are most often localized in the uterus, but can also appear inside the vagina. When damaged, characteristic pink discharge occurs.

Oncological diseases of the pelvic organs . Malignant tumors at first proceed without symptoms. The development of the disease can be suspected by a change in the volume and color of vaginal discharge. They often turn pink, with intermenstrual uterine bleeding.

If pathological discharge from the genital tract appears, an urgent need to consult a doctor.

Regardless of the nature and amount of mucus, a woman should always maintain good hygiene.Carefree® panty liners make it much easier to care for your intimate area, absorb secretions quickly and stay comfortable under all circumstances.

Menstrual Cycle Information for Girls

Menstrual cycle (Latin menstrualis monthly, monthly) – cyclical changes in the organs of a woman’s reproductive system, the main manifestation of which is monthly spotting from the genital tract – menstruation. Menstruation begins at puberty.The first menstruation (menarche) occurs, as a rule, at the age of 12-14 years, much less often at 9-10 years (early menarche) or 15-16 years (later menarche). At the beginning of the menstrual cycle, it is anovulatory in nature (ovulation does not occur – rupture of the ovarian follicle and release of the egg into the abdominal cavity), menstruation is often irregular. Within 1-1.5 years after the onset of menarche (the period of the formation of the cycle), the menstrual cycle becomes regular and from anovulatory it turns into an ovulatory one with rhythmic processes of follicle maturation, ovulation and the formation of a corpus luteum at the site of a burst follicle.After 16 years, a certain rhythm of the menstrual cycle is usually established – from the beginning of menstruation to the first day of the next menstruation, 21-32 days pass. In 75% of women, the duration of the menstrual cycle is 28 days, in 10% – 21 days, in 10% – 32 days. Menstrual bleeding lasts an average of 3-5 days. During the entire reproductive period of a woman’s life (on average, from 18 to 45 years), the menstrual cycle, as a rule, does not change, with the exception of periods of pregnancy and lactation, when menstruation stops.In the premenopausal period, which usually occurs after 45 years, the menstrual cycle is disrupted due to the extinction of the hormonal and reproductive function of the ovaries. Ovulation becomes irregular, then persistent anovulation develops, the interval between periods increases and, finally, the last menstruation occurs, often referred to as “menopause” (on average, this occurs at the age of 50). The period lasting 6-8 years after menopause is called postmenopause.

In the first (follicular) phase of the menstrual cycle, follicles grow and mature in the ovaries (Fig.a), one of which is dominant, or leading, estrogens are produced in its cells. In the middle of the menstrual cycle, this follicle bursts and the mature egg enters the abdominal cavity (ovulation). After ovulation, the second (luteal) phase of the menstrual cycle begins, during which a corpus luteum forms in place of the bursting follicle, which produces progesterone. By the end of the menstrual cycle, if fertilization has not occurred, the corpus luteum regresses. After 16 years, a certain rhythm of the menstrual cycle is usually established – from the beginning of menstruation to the first day of the next menstruation, 21-32 days pass. In 75% of women, the duration of the menstrual cycle is 28 days, in 10% – 21 days, in 10% – 32 days. Menstrual bleeding lasts an average of 3-5 days. During the entire reproductive period of a woman’s life (on average, from 18 to 45 years), M. c., As a rule, does not change, with the exception of periods of pregnancy and lactation, when menstruation stops. In the premenopausal period, which usually occurs after 45 years, the menstrual cycle is disrupted due to the extinction of the hormonal and reproductive function of the ovaries.Ovulation becomes irregular, then persistent anovulation develops, the interval between periods increases and, finally, the last menstruation occurs, often referred to as “menopause” (on average, this occurs at the age of 50). The period lasting 6-8 years after menopause is called postmenopause.

Medical Center Axon

Polyps are small, soft, finger-like growths on the lining of the uterus (endometrium) or on the cervix (polyps of the cervix or cervical canal). Polyps may be single or multiple (polyposis), soft or dense, pedunculated or broad-based.

Most polyps are benign growths. Polyps are usually reddish brown or gray-white in color. They can vary in size and often look like a “light bulb” on a thin stem through which the vessel that supplies the polyp passes.

Manifestations of the disease

In most cases, polyps do not cause symptoms.However, you may experience:
• A foul-smelling discharge (leucorrhoea) that turns yellowish, especially if the polyp is infected.
• vaginal bleeding after menopause;
• bleeding or spotting between periods;
• profuse and painful and irregular menstruation;
• bleeding or spotting after douching or intercourse;
• infertility;
• pulling pains in the lower abdomen;
• pain or discomfort during sexual intercourse;
• anemia, accompanied by pallor of the skin, dizziness, weakness.

Factors in the development of the disease

The main reasons for the formation of cervical polyps are the postponed trauma of the cervix, endocrine disorders, etc. Often polyps are combined with chronic inflammatory diseases of the female genital area, erosion, uterine myoma, endometriosis, ovarian dysfunction, etc.
The formation of endometrial polyps begins with malfunction the natural mechanism of self-cleaning, which may be a consequence of chronic inflammatory diseases of the genital organs, as well as postponed abortions.
The spontaneous appearance of polyps is also caused by an increase in the woman’s blood level of hormones – estrogen. Such an increase in hormone levels is possible after the use of oral contraceptives, during pregnancy or after hormone therapy.

Classification of polyps

• glandular polyps, formed from endometrial tissue containing glands;
• glandular fibrous polyps, which are a combination of glands in the inner lining of the uterus and connective tissue;
• fibrous polyps (in women after forty years), consisting of dense fibrous tissue containing single glands;
• adenomatous polyps (have a high risk of progression to endometrial cancer).

Diagnostics

– Gynecological examination
– Ultrasound of the pelvic organs
– Hysteroscopy.

Treatment

Treatment of cervical polyps consists in their removal by laser, radio wave or surgery, followed by histological examination (it is necessary to exclude oncopathology). If necessary, hormone therapy is prescribed. Endometrial polyps can be removed during hysteroscopy – a procedure performed using special endoscopic equipment – a hysteroscope, which allows you to carefully examine and carry out the necessary manipulations in the uterine cavity.Since in women during menopause, the presence of endometrial polyps is often combined with its hyperplasia (thickening), at this age curettage of the uterine cavity is indicated.

Curettage of the endometrium (uterine cavity) and cervix (cervical canal) – surgical manipulation, which is carried out to diagnose the state of the endometrium, followed by histological analysis of scrapings.
If there are indications and on the basis of histological examination data, an individual program for the treatment of the identified disease is developed for each patient.
This procedure is not only diagnostic, but also therapeutic, since during it the pathological focus in the uterine cavity is removed.
Separate therapeutic and diagnostic curettage of the uterine cavity and cervical canal is shown:
• for various disorders of the menstrual cycle;
• with dysfunctional uterine bleeding;
• with polyps of the endometrium and cervical canal;
• after spontaneous abortion;
• in case of infertility;
• for suspected oncology and endometrial tuberculosis.
Acute infectious diseases and inflammatory processes of the genital organs are absolute contraindications to curettage. Therefore, before medical and diagnostic curettage, a gynecological examination, ultrasound, ECG, clinical and biochemical blood tests, blood for HIV, syphilis, hepatitis are performed without fail.
The operation of medical and diagnostic curettage lasts about 20 minutes and is carried out under intravenous anesthesia or spinal anesthesia, which completely eliminates pain.
At the end of the procedure of medical and diagnostic curettage, the patient is transferred to a comfortable ward, where she is under the supervision of an anesthesiologist and nursing staff for several hours. After the end of the anesthesia, the patient can be discharged from the clinic.

90,000 American women complained of painful periods after COVID-19 vaccination

Women who have been vaccinated against the coronavirus complain of changes in the menstrual cycle, according to American doctors.The reason for this is unclear – it is possible that increased bleeding and pain are associated with stress and superimposed discomfort from the vaccine administration. At least a mechanism has not yet been found that would allow the vaccine to interfere with the menstrual process.

Dr. Keith Clancy of the University of Illinois at Urbana-Champaign heard a complaint about changes in the pattern of menstruation after vaccination from a colleague and then encountered them herself.

Medic wrote about this on Twitter, and dozens of women responded to her post, reporting that periods really became more difficult after vaccination.

It didn’t matter which vaccine was used – from Pfizer / BioNTech, Moderna, AstraZeneca or Johnson & Johnson.

“Exactly two weeks after the second dose, my period began, 12 days earlier than necessary, and went harder than in the last three years.” on you … 16 days of bleeding with the usual five “,” I have not had an intrauterine hormonal system and have not had menstruation for many years, but today there is pain and a little discharge.Nothing serious, it was worth it, but still strange! ”Wrote the users. Symptoms were also discussed on other Internet sites.

Most often, women complained of severe pain and an interrupted cycle.

However, some noted that their menses had not changed in any way.

Clancy is currently collecting data to better understand the relationship between vaccination and menstruation.

“After being vaccinated on the third day of my period, I still had to use several pads with maximum absorbency per day, although usually one or two regular pads were enough,” she tells Daily Mail .- Is this due to the fact that the vaccine increases the inflammatory response? Anyway, I’m intrigued. Inflammation plus tissue renewal – that’s bleeding. ”

The US Centers for Disease Control and Prevention has its own vaccine-related adverse event reporting system. Specialists of the Centers, however, cannot yet say for what reason women observe changes in the menstrual cycle – there is too little data.

Perhaps the pain seems to be stronger, because the soreness and aches in the body, which is observed in many vaccinated people, are added to the usual sensations during menstruation.

The issue is more complicated with increased bleeding. A small 90,015 study of 90,016 177 women of reproductive age who underwent COVID-19 showed that more than half of them experienced menstrual changes, and in most cases it was more painful or prolonged periods. Perhaps the vaccine is capable of producing a similar effect – for now, we cannot say for sure.

It is also possible that it is a matter of stress.

“The menstrual cycle can change and is influenced by many factors, including stress, poor sleep, exercise and certain medications,” explains Dr. Gloria Bachman of the Robert Wood Johnson School of Medicine.-

And it is not unusual for some women to notice changes in their periods after vaccination, such as an earlier onset, more profuse discharge, or more severe cramping than usual. ”

Doctors doubt that the vaccine can directly affect the menstrual cycle.

“There is no biological mechanism that explains menstrual irregularities following COVID-19 vaccination,” says Dr. Mark Turrentin of Baylor College of Medicine.He notes that during clinical trials, none of the vaccine manufacturers reported such side effects.

Women who have noticed changes in the menstrual cycle after vaccination, doctors advise not to panic. Perhaps the changes are not related to her, but to other factors. However, if the bleeding continues, it is best to see a doctor. Regardless of the reasons, in such a situation, an examination may be necessary.

90,000 Irregular or excessive uterine bleeding

Irregular or excessive uterine bleeding is one of the most common reasons for visiting a gynecologist, and in general, in frequency, it can compete only with inflammatory diseases of the genital organs.

During the follicular phase (phase 1) of the menstrual cycle, under the influence of estrogen, the thickness of the endometrium increases. At the histological level, this process is manifested by an increase in the number of mitoses in the glands, that is, the endometrium grows. During the luteal phase (phase 2), progesterone produced by the corpus luteum stops the growth of the endometrium, causes secretory transformation in it, providing conditions for implantation of a fertilized egg. At the end of the menstrual cycle, if pregnancy has not occurred, due to the regression of the corpus luteum in the blood, the levels of female sex hormones fall, which leads to the onset of menstrual bleeding.

The onset and completion of normal menstrual bleeding requires a clear interaction between hormonal influences and the endometrium. During the luteal phase of the menstrual cycle, the endometrium consists of three layers: the basal layer, the spongy layer and the compact layer. The basal layer is located on the border between the myometrium and the endometrium, and it is from it that the endometrium is renewed in each new cycle. The spongy layer, following the basal layer, is the thickest layer, occupying half of the entire thickness of the endometrium in the second phase of the cycle. Spiral arteries are located in the spongy layer.

The vascular structure of the endometrium is a continuation of the vessels of the myometrium. The arcuate arteries of the myometrium, branching out, form the radial and basal arteries, which begin to twist and create the so-called spiral arteries that penetrate the endometrium. The spiral arteries, in contrast to the basal ones, are sensitive to fluctuations in estrogen and progesterone, which ensures the process of desquamation of the functional layer of the endometrium due to vasoconstriction, leading to ischemia and necrosis.After the completion of desquamation, the basal arteries begin to regenerate. At the microscopic level, 4 stages are distinguished in this process: a) destruction of the basement membrane; b) migration of endothelial cells; c) proliferation of endothelial cells; and d) formation of a capillary. In the process of degradation of the basement membrane, specific enzymes (stromelysin, collagenase, etc.) destroy the elements of the extracellular matrix. The endothelial cells then migrate to the end of the vessel, which is facilitated by an environment rich in type I and III collagen and the stimulating effect of bFGF.Further proliferation of endothelial cells and lumen formation are probably also dependent on the components of the extracellular matrix.

Thus, the mechanism by which complications of pregnancy can lead to uterine bleeding becomes apparent. The process of embryo implantation includes the invasion of the trophoblast into the endometrium, in which the development of the local vasculature in the endometrium plays a significant role, providing conditions for the further course of pregnancy.In cases where pregnancy for one reason or another begins to be interrupted, the maternal vessels open into the uterine cavity, which leads to the development of bleeding.

Tumors of the uterus cause bleeding due to the destruction of the normal integrity of the endometrial structure. Uterine bleeding caused by endometritis is a consequence of the destruction of the vessels and glands of the endometrium by substances produced during inflammation.

The first stage in the formation of a thrombus is platelet aggregation, therefore, any diseases accompanied by impaired platelet aggregation (thrombophilia, disorders in the hemostasis system, thrombocytopenic purpura, etc.)) can lead to uterine bleeding.

Among the hormonal disorders leading to pathological uterine bleeding, the leading place is occupied by anovulation. The essence of anovulatory bleeding is prolonged stimulation of the endometrium with estrogens in the absence of progesterone, which leads to excessive growth of the endometrium and its periodic rejection due to degenerative processes in the surface layers.

Hormonal disorders leading to pathological uterine bleeding

Normal cyclical uterine bleeding – menstruation – is known to require sequential stimulation of the endometrium with estrogens and then progesterone, followed by a drop in their concentrations in the blood, which leads to the onset of physiological desquamation of the endometrium.

A critical moment in each menstrual cycle is ovulation – it either occurs or does not occur, or ovulation occurs in a defective follicle. In principle, the nature of the subsequent uterine bleeding largely depends on this – the physiological desquamation of the secretory endometrium or the rejection of the functional layer of the endometrium due to dystrophic processes. In cases of ovulation of a defective follicle, the corpus luteum that has arisen in its place is defective, and the progesterone produced by it is insufficient and there is a deficiency of the luteal phase (LF).In other words, adequate progesterone production is a guarantee of a normal menstrual cycle, of course, in the absence of organic diseases.

Dysfunctional uterine bleeding is a collective term for pathological uterine bleeding resulting from hormonal disorders in the absence of pregnancy, organic disorders, inflammatory diseases and changes in the hemostatic system.

There are many reasons for ovulation disorder. In most cases, the first menstrual cycles after menarche are anovulatory, however, in the future, with the normal functioning of all systems, the cycles become ovulatory.Normally, 2-3 years after menarche, the menstrual cycle can be anovulatory with a characteristic irregularity. Among the most common reasons that prevent ovulation in the early stages, one can single out dysfunction of the hypothalamic-pituitary complex due to neuroinfections, trauma, malformations, endocrinopathies, as well as other reasons due to insufficient body weight and mental factors, etc.

In the middle reproductive age, the causes of anovulation associated with inflammatory diseases of the appendages, hyperprolactinemia of various origins, diseases of the adrenal glands and thyroid gland, abortions, improper use of hormonal contraceptives, polycystic ovary syndrome, and postpartum complications come to the fore.
For the late reproductive period, conditions associated with the extinction of reproductive function are added to the causes characteristic of middle age. Depletion of the follicular apparatus, decreased sensitivity of the ovaries to the stimulating effects of gonadotropins, somatic diseases – all this does not contribute to full ovulation.

Dysfunctional uterine bleeding is most common in adolescence and premenopausal age and is similar in its mechanism of development.If for adolescence anovulation and, as a result, irregular menstruation mostly lead to psychological problems, and at a later age to unsuccessful attempts to get pregnant, then for women in premenopausal age, anovulation can be the cause of endometrial hyperplastic processes.

The greatest risk of developing endometrial hyperplastic processes and endometrial carcinomas (cancer) is observed in women of premenopausal age, especially against the background of increased body weight.It is assumed that the extra-ovarian synthesis of estrogens in adipose tissue, due to the fermentation of androgens into estrogens, adding up with estrogens of ovarian origin, leads to an increase in proliferative processes in the endometrium, which, in the absence of adequate progesterone production, creates a background for the formation of hyperplasia. However, in addition to hyperestrogenism and progesterone deficiency, other factors are needed for the development of the hyperplastic process. I wonder why in young girls with increased body weight and anovulatory menstrual cycle, hyperplastic processes of the endometrium develop extremely rarely? Taking into account the results of several recent studies, most likely a large role in the formation of endometrial hyperplastic processes is played by chronic endometritis resulting from sexually transmitted infections, a large number of invasive gynecological interventions, and endometriosis of the uterus (adenomyosis).

It is quite easy to diagnose anovulatory menstrual cycle. Clinically, it is characterized by oligomenorrhea, that is, the patient complains of “irregular menstrual cycle with delays.” An ultrasound examination, depending on the phase of the cycle, can confirm the diagnosis. In general, an ultrasound examination against the background of anovulation in the ovaries can detect small follicles (dysfunctional uterine bleeding due to follicle atresia), a persistent follicle (dysfunctional uterine bleeding due to follicle persistence). The thickness of the endometrium will depend on the time since the last menstrual period and the amount of estrogen produced by the ovaries. Also an important criterion will be the absence of a corpus luteum.

For dysfunctional uterine bleeding, the cause of which is insufficiency of the corpus luteum (LF), polymenorrhea is characteristic, that is, menstruation in such a patient will come regularly, but in less than 21 days. Diagnostic criteria for this condition can be: a low level of progesterone in the second phase of the menstrual cycle with the established fact of ovulation, a short (less than 10 days) hyperthermic phase on the basal temperature graph.

Treatment

Treatment of dysfunctional uterine bleeding should be aimed at eliminating the cause that caused anovulation, or at least at restoring progesterone deficiency. However, the first thing you have to deal with is stopping the bloody discharge. After a carefully collected history, exclusion of pregnancy and organic causes of this bleeding, it is necessary to resort to hormonal hemostasis. If bleeding occurs at least 14 days after the last menstruation, or according to ultrasound studies, the thickness of the endometrium is more than 6-7 mm, the appointment of gestagens is shown, for example, norkolut 1 tablet 2 times a day for 10-15 days.It is important to explain to the patient that if bleeding has stopped while taking progestogens, it is impossible to stop taking the pills. Usually, after the end of the 10-15 day intake of gestagens, normal menstruation comes in 2-3 days.

Bleeding in the first phase of the menstrual cycle is most often associated with a lack of estrogens, which can be replenished by introducing them from the outside, for example, in the form of oral contraceptives.

If it is established that the cause of anovulation is: chronic stress, low body weight, or inflammatory diseases of the uterus and appendages, then weight gain, psychotherapy and the use of antibiotic therapy should lead to the normalization of menstrual function.If the above reasons are leveled, others could not be identified, and menstrual function was not restored, there are two ways: prescribing oral contraceptives for at least 3 months in order to cause the so-called “rebound effect” (withdrawal effect) and the second way – induction of ovulation. Obviously, for the first and second pathways, the “first day of the menstrual cycle” is required, which, in the case of prolonged absence of menstruation, can be induced by the administration of progesterone.

Hormonal causes of ovulation disorders can be hyperandrogenic states of various origins and polycystic ovary syndrome, as well as thyroid disease and hyperprolactinemia.Etiotropic treatment of these diseases most often leads to the normalization of menstrual function.

The most common organic causes of uterine bleeding include endometrial and cervical polyps, endometrial hyperplasticity, and bleeding due to the presence of uterine fibroids or internal endometriosis (adenomyosis). All these conditions can most likely be detected by ultrasound examination in combination with standard clinical examination.

If the mechanism of development of uterine bleeding against the background of polyps and endometrial hyperplasia is obvious, then there are still no unequivocal opinions regarding the causes of uterine bleeding caused by uterine myoma.

Table # 1 Normal indicators of the menstrual cycle

Thus, any deviations from the figures given in the table should be considered as a manifestation of a pathological process, the cause of which must be found.

Menstrual irregularities can be divided into three groups: irregularities, changes in the duration of menstruation and changes in the amount of blood lost (Table 2).

Table No. 2 Variants of menstrual irregularities

Irregular or excessive uterine bleeding can be due to a variety of reasons (Table 3).

Table No. 3 Causes of menstrual irregularities

All information is for informational purposes only. If you have any health problems, then you need to consult a specialist.

Read also

90,000 Abundant menstruation – diagnosis and treatment at the KST clinic

Let’s start with the terminology.What is Heavy Menstruation? Where is the line between norm and pathology?

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Prices for the treatment of pathological menstrual bleeding

• Consultation of an obstetrician-gynecologist, treatment and diagnostic, primary, outpatient 1 900
• Reception of an obstetrician-gynecologist, therapeutic and diagnostic, repeated, outpatient 1 700
• Visiting an obstetrician-gynecologist on menopause problems with vaginal Ph-metry (primary) 2 800
• Appointment of an obstetrician-gynecologist on the problem of menopause (repeated) 2 200
• Ultrasound of the pelvic organs of a woman 2 100
• Diagnostic hysteroscopy 12 000

• Appointment

Questionnaire for identifying pathology of the menstrual rhythm

Our Clinic has developed a questionnaire that allows you to independently assess your condition and make a decision on the need to visit a doctor.

Pathological menstrual bleeding is considered to be such a type of blood loss, in which a woman’s working capacity and quality of life are significantly reduced, and iron deficiency anemia develops.

Causes of menstrual bleeding.

In the scientific community, menorrhagia is usually subdivided into:

• associated with uterine pathology;
• not associated with uterine pathology;
• hemorrhages of the changeopausal period.

This diversity is due to the complex hormone- and neuroendocrine-dependent regulation of a woman’s reproductive function.Therefore, the reasons leading to a violation of the monthly cycle can be detected in various organs that are not directly related to the reproductive system, such as the hypothalamus, thyroid gland, adrenal glands, cerebral cortex, ovaries.

Most often, the causes of bleeding are due to the pathological process of the uterus. The peculiarity of this body is in the fast and even, one might say, “timely” signaling for any deviation from the norm.

Diseases of the uterus causing abnormal menstrual bleeding:

• Adenomyosis or the old name “internal endometriosis”.With this disease, due to reasons not yet known to science, foci of ingrowth of the endometrium into the muscular layer of the uterus are formed. In addition to its pronounced symptoms, the disease has a negative effect on fertility.
• Polyps, which are both single and multiple. This benign pathology is characterized by the proliferation of the glandular layer of the endometrium. Polyps have a characteristic anatomical structure and consist of a peduncle and a body.
• Benign tumor of the smooth muscle layer – Myoma.The most common gynecological pathology. Myomatous nodes are single and multiple. The clinical picture depends on their size, location and quantity.
• Malignant neoplasms developing both in the endometrium and in the muscle layer and requiring immediate surgical treatment.

Our Clinic has been specializing in the provision of gynecological care for 24 years. We have built the structure of work in such a way that each office can function as a “mini-clinic”.This is a very convenient format for both patients and doctors, which makes it possible to carry out most of the examinations and manipulations during one appointment. The center has an operating room equipped with an endoscopic optical one for therapeutic and diagnostic hysteroscopy. This type of research is widely used to verify the diagnosis of metrorrhagia.

As we have already said, changes in the menstrual cycle are also caused by various extragenital pathologies. When compiling an examination program, an obstetrician-gynecologist must show remarkable professional erudition and ingenuity in order to timely identify and exclude:

• various types of ovarian hormonal dysfunction;
• diseases of the thyroid and adrenal glands;
• blood diseases;
• liver disease;
• state of prolonged stress and psychoemotional disorders;
• long-term uncontrolled intake of anticoagulants, non-steroidal anti-inflammatory drugs.

Particular attention should be paid to women of premenopausal age. After all, they, against the background of estrogenic aging, shorten the intervals between menstruation. As a result, the body does not have time to fully recover from blood loss. Vivid clinical signs of anemia develop, expressed by complaints of shortness of breath during physical exertion, palpitations, increased fatigue, and loss of working capacity. Among other things, such patients have a higher risk of detecting malignant tumors, which must be taken into account by the doctor conducting the examination.

Diagnostics

Evaluation of patients with abnormal menstrual flow begins with ultrasound testing. In experienced hands, this routine procedure allows in 80% of cases to identify the cause of menorrhagia. The study is carried out on days 2-7 of menstruation and does not require special preparation.

When detecting polyps and endometrial pathology for therapeutic and diagnostic purposes, we recommend hysteroscopy. This endoscopic technique allows you to examine the uterine cavity, identify and immediately remove pathological foci.The material obtained during the operation is sent to histologists for the final diagnosis.

If masses are detected and the malignancy of the process is suspected, MRI of the pelvic organs is prescribed.

Laboratory diagnostics is mandatory for diagnosis and therapy. A general blood test with serum iron, biochemical and hormonal parameters, a hemostasiogram, and tumor markers are routinely analyzed.

Careful collection of anamnesis, a well-built diagnostic algorithm allows you to diagnose the cause of bleeding and start targeted treatment.

Treatment

Building tactics, we strive, first of all, to preserve the woman’s fertile function, to return her to her usual quality of life and to neutralize the consequences of blood loss.

We recommend radical surgery only when other methods have not been shown to be effective, the disease is progressing and childbirth is not planned. Of course, this does not apply to bleeding caused by malignant formations that require immediate surgical intervention in a specialized hospital.In all other cases, we choose a careful organ-conserving strategy.

• Hormone therapy is aimed at reducing the estrogen-progestogen-progesterone imbalance. Depending on the woman’s preference, both oral and intrauterine hormonal agents are prescribed. The Mirena intrauterine device is successfully used to normalize hormonal imbalance and stop endometrial proliferation. We recommend its installation for the treatment of adenomyosis, recurrent endometrial polyps (after their removal), ovarian dysfunction.
• Nonsteroidal anti-inflammatory drugs – have the ability to block the production of tissue mediators of inflammation, prostaglandins, in the body. Taking them during critical days reduces inflammation and spastic activity of the uterus. As a result, the duration and abundance of secretions are shortened, and the pain syndrome is stopped. Recall that with prolonged use of the substance, they cause unwanted complications in the digestive and hematopoietic systems.
• Antifibrinolytic substances are recommended to be prescribed to normalize the hemostatic system.Indeed, in most patients suffering from menstrual blood loss, there is an increased fibrinolytic activity of the blood. As a result, the fibrin clot necessary to stop bleeding is formed with a delay, as a result, the time and abundance of blood loss are lengthened.
• Separate diagnostic curettage under the control of hysteroscopy is a therapeutic, minimally invasive procedure that allows, under eye control, to identify and immediately remove changes in the endothelium and the mucous membrane of the uterine cavity.
• For anemia, iron supplements are prescribed, which are available both in tablets and in injections. Depending on the degree of iron deficiency, one or another method of administration is prescribed.
• I would like to say that regular physical activity, a healthy lifestyle, good nutrition and rejection of bad habits can normalize the monthly calendar without medication, reduce the degree and severity of hemorrhages, and relieve pain.