Bleeding between periods: causes and symptoms

Bleeding between periods, also known as metrorrhagia, is a loss of blood of varying severity that occurs before or after menstruation.

In women of childbearing age, menstruation occurs on average once a month and marks the start of a new menstrual cycle. Menstrual bleeding typically lasts between 3 and 7 days and then subsides naturally.

Although menstruation may be irregular in some women, it occurs only once per cycle. When bleeding occurs outside the menstrual phase, it is referred to as intermenstrual bleeding.

Metrorrhagia may be a sign of a significant imbalance and requires medical attention.

Bleeding outside of menstruation is similar to a real period, even if it may be slightly lighter. It generally lasts several days, just like a period, and can be confusing for women. It’s important to distinguish between metrorrhagia and simple spotting.

What is spotting?

Spotting is very light, harmless bleeding. It can occur outside of the menstrual period and last for a few days. Generally, spotting is pinkish or brown in colour.

Bleeding outside of your period may be accompanied by various symptoms:

• Abdominal pain 

• Cramps

• Vaginal discharge

• Fatigue 

• Anemia 

• Vaginal itching 

• Symptoms of PMS (Premenstrual Syndrome).

Please do not hesitate to contact your doctor if you experience bleeding outside of your menstrual period associated with one or more of these symptoms.

Just as with painful periods, the potential discomfort associated with intermenstrual bleeding depends on the underlying cause. It is common for pain of varying intensity to occur in the lower abdomen, accompanying bleeding outside of your period. The pain associated with breakthrough bleeding can vary greatly from one woman to another. Don’t hesitate to consult your doctor if you experience pain.

Abnormal bleeding in women can be caused by several factors:

• Ectopic Pregnancy: One of the first causes to rule out in cases of bleeding between periods is an ectopic pregnancy. When an embryo implants outside the uterus (in a fallopian tube, for example), bleeding may occur. Immediate medical attention is required in the case of an ectopic pregnancy

• Hormonal imbalance: Certain hormonal changes can lead to intermenstrual bleeding. Women undergoing hormonal changes, such as young girls during puberty, postpartum women, or women in perimenopause, may experience bleeding outside of their menstrual periods

• Uterine polyps: A uterine polyp is a growth of tissue that develops inside the uterine cavity. When polyps form and grow in size, the regulation of menstrual bleeding may be affected at the level of the uterine wall. This can lead to bleeding outside of menstruation

• Pelvic infections: Certain infections of the female reproductive system can lead to intermenstrual bleeding. This is the case, for example, with vaginitis (inflammation of the vagina) or cervicitis (inflammation of the cervix)

• Use of contraceptives: When taking oral contraceptives, bleeding may occur outside the expected menstrual period. This happens when the pill is not taken as directed, particularly if doses are missed or taken at irregular times.  The insertion of an IUD (intrauterine device) can also cause bleeding if it is not properly positioned or if the body has difficulty tolerating it.

Note: In some cases, the presence of benign fibroids in the uterus can also cause bleeding.

Can you bleed during ovulation?

Ovulation is a physiological process during which a woman’s egg is released from the ovary at the end of the follicular phase. Usually, menstruation occurs about two weeks after ovulation in a regular menstrual cycle. 

However, bleeding may sometimes occur at the time of ovulation. This phenomenon, known as ovulatory metrorrhagia, is generally caused by the release of blood into the peritoneal cavity following the rupture of the ovarian follicle. 

Ovulation can also cause mild uterine contractions that may lead to bleeding. 

Bleeding outside of your period is generally harmless. However, it is essential to consult a doctor to rule out a more serious issue and establish an appropriate treatment plan if necessary.

In daily life, the unexpected nature of bleeding can interfere with a woman’s well-being and sexual health. If you experience bleeding outside of your menstrual period, seek advice to receive professional support.

Here are our recommendations for bleeding between periods: 

Consult a healthcare professional: The steps to take in case of bleeding between periods depend on the cause of the bleeding. To understand the source of the problem, contact your primary care physician and get a clear diagnosis. Following this, you can implement a treatment plan tailored to your needs with full knowledge of the facts.

Keep a menstrual diary: To understand what’s happening in your body, why not keep a menstrual diary? A menstrual diary involves taking notes throughout your cycle. Be sure to note the date, intensity, and duration of your bleeding, as well as any associated symptoms. Recording what happens in your body throughout the month will help you better understand your body.

Learn to manage stress: Stress is known to affect the female menstrual cycle. Whatever the underlying cause of the bleeding, a calm and peaceful daily routine is essential for restoring balance. Modern life certainly comes with its share of stress! But it is possible to learn how to manage it effectively. Explore relaxation techniques such as yoga, meditation, or exercise.

Bleeding between periods can be a source of worry and discomfort for many women. While there are natural solutions to maintain well-being and help restore balance, it is essential to seek guidance from a qualified professional to resolve the issue. If you experience bleeding outside of your menstrual period, don’t wait to seek medical advice to determine the underlying causes.

Marine is a naturopath specialising in children’s well-being and a parenting coach. With 10 years’ experience supporting families, she now channels her passion into serving her community by sharing natural and caring advice.