Why Am I Bleeding Between Periods?

This serious symptom usually requires attention from a healthcare provider

Pantyliner, packed sanitary pad and tampon, close up
Getty Images/Dorling Kindersley

Bleeding or spotting between regular monthly periods can be a frightening experience, and is usually a symptom of a larger problem.

There are several possible causes of vaginal bleeding, which we’ll discuss shortly. However, for post-menopausal women or pre-pubescent girls (who have not yet experienced puberty), vaginal bleeding should prompt an immediate call to a healthcare provider. It’s also advisable to call your healthcare provider if you’re bleeding between your normal monthly periods.

What Is Normal Menstruation?

Normal menstrual bleeding lasts about five to seven days, and although it may seem like you are losing a lot of blood, it usually only measures between two and eight tablespoons. While menstruation usually occurs an average of every 28 days, anywhere from 21 to 35 days between periods is considered normal. Most women get to know their own cycles after a few years of menstruating.

What Causes Bleeding Between Periods?

Some women may experience spotting during ovulation, which is normal. Although the reasons for irregular bleeding can vary according to individual health situations, some of the more common causes include:

  • Implantation bleeding/pregnancy
  • Miscarriage
  • Abortion
  • Hormonal fluctuations
  • Starting, stopping, or missing oral contraceptives or estrogens
  • Low thyroid levels
  • Stress
  • IUDs
  • Injury to the vagina from insertion of foreign objects
  • Malignant cancers
  • Uterine fibroids
  • Undiagnosed vaginal infections
  • Certain drugs, particularly anticoagulants
  • Vaginal dryness
  • Certain gynecological procedures

What Your Healthcare Provider May Recommend for Irregular Vaginal Bleeding

Bed rest may be recommended if the bleeding occurring between your periods is heavy. Use your menstrual cycle calendar to record the number of tampons or pads you use.

This information can help your doctor determine whether or not you are bleeding excessively.

Unless your doctor specifically advises otherwise, don’t take aspirin while you are menstruating. Aspirin can thin the blood, which may cause bleeding to last longer and flow more heavily.

You should expect to give your full medical history when you visit your healthcare provider for diagnosis of bleeding or spotting between periods. Also expect to have a pelvic exam, including a Pap smear if you haven't had one recently.

If you've kept a menstrual cycle calendar, it will help answer any questions your healthcare provider may have about your bleeding. These questions may include:

  • How long have you experienced bleeding between periods?
  • Does it happen every month or is this the first time?
  • At what point during your menstrual cycle did the bleeding begin, and how long did it last?
  • Do you experience menstrual cramps when bleeding between periods occurs?
  • Does anything make the bleeding worse, or better?
  • Is the bleeding worse with increased physical activity?

In addition, your healthcare provider may ask about your stress level,  and whether you have other symptoms such as pelvic pain, increased bruising, difficulty swallowing and pain or burning during urination.

And if there’s blood in your stool or urine, this is definitely something to bring to your healthcare provider’s attention.

Remember to inform your healthcare provider about any prescription or over-the-counter medications (including herbal supplements) that you are taking.

Vaginal Bleeding and a New Healthcare Provider

If you’re visiting a new healthcare provider who isn’t familiar with your medical history, she’ll want to know how old you were when you started having periods, whether you’re sexually active and what birth control method you may be using.

Obviously, she’ll want to know about any history of bleeding between periods, and whether this is a symptom other women in your family may have suffered.

 It's also important to advise your physician if you are pregnant or recently had a miscarriage or abortion. If you have had a D&C procedure, your healthcare provider should know this as well.

If you have experienced any injuries or had medical or surgical treatments, this is also important to tell your physician or nurse practitioner.

How to Diagnose Vaginal Bleeding

The treatment for your vaginal or uterine bleeding will depend on the answers to your health care provider’s questions, as well as the findings of your pelvic exam. Based on the initial evaluation there may be additional tests or treatment needed. But always treat unexplained or unfamiliar vaginal bleeding as the serious symptom it is.


MedlinePlus: Vaginal Bleeding Between Periods Accessed 02/2017

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