Bleeding Between Periods: Should I Be Concerned?

Spotting or bleeding between periods can be alarming, especially if it’s not something you’ve experienced before. While it may be harmless and not a major health concern, abnormal bleeding isn’t something to dismiss.

At North Atlanta OB/GYN in Atlanta, Alpharetta, and Marietta, Georgia, we understand how alarming abnormal bleeding can be. Our message to you: Don’t panic, but do get it checked out. 

An evaluation can ease your concerns and help ensure your health stays on track. 

About your menstrual cycle

To better understand why bleeding between periods may happen, let’s start with a quick overview of a normal menstrual cycle. A typical cycle lasts between 21 and 35 days, averaging about 28 days. Your cycle is driven by the rise and fall of your female sex hormones and has four phases:

During the follicular phase, your uterus thickens with blood in preparation for pregnancy. Ovulation is when the ovaries release an egg for fertilization by joining with sperm.

If pregnancy doesn’t happen, hormone levels drop and you enter the luteal phase, prompting your uterus to shed its lining, marking the start of the menses phase, or your monthly period. A normal period lasts three to seven days.  

What about bleeding between periods?

Bleeding outside of your regular period — also called intermenstrual bleeding, metrorrhagia, or spotting — isn’t normal. This is true whether the bleeding is light or heavy, occuring at any point in your cycle outside of the menses phase.

Breakthrough bleeding during your cycle is common and can happen for many reasons. However, there’s a slim chance that the bleeding could be related to an underlying health condition, so it’s something you should take seriously and get checked out. 

Causes of abnormal bleeding

If you experience bleeding between periods, make a note of when it happens, how heavy it is, and whether it’s associated with specific activities, such as after intercourse. These details help us narrow down possible causes.

Some of the most common causes of bleeding between periods include:

Hormones

Hormonal changes are a frequent cause of spotting. It can occur as a side effect of perimenopause, hormone replacement therapy (HRT), or hormonal contraception.

Polycystic ovary syndrome (PCOS) and thyroid disorders are other hormone-driven causes of bleeding between menstrual periods. 

Infections 

Infections like gonorrhea, chlamydia, and herpes may lead to unexpected bleeding, as can pelvic inflammatory disease (PID).

Abnormal growths

Abnormal growths like polyps or fibroids can also cause bleeding outside your normal cycle. Such growths may also induce heavier bleeding during your menses.

Pregnancy complications

Spotting during pregnancy is a concern because it can be a potential sign of complications, such as pregnancy loss.

Other medical conditions

Medical conditions like diabetes and liver disease may contribute to bleeding in between periods. 

Reproductive cancer

Most concerning, however, is that the bleeding may be due to reproductive cancer. Though less common than the conditions mentioned above, it’s the most serious and one we need to rule out during an evaluation. 

The bottom line? Spotting from perimenopause and spotting from cancer may look the same. A medical evaluation is the only way to determine the cause and ensure nothing serious goes undetected. 

If you’ve noticed abnormal uterine bleeding, we can uncover the cause and create a personalized plan to address it. Call North Atlanta OB/GYN today or book an appointment online.