It refers to the vaginal bleeding among premenopausal women that is not synchronized with their menstrual period. It is often referred to as spotting. It is the bleeding between the periods.

Make sure the bleeding is coming from vagina and not from rectum or in the urine. Inserting a tampon into the vagina will confirm the vagina, cervix or uterus as the source of bleeding.

Causes

• Endometriosis.
• Ectopic pregnancy.
• Hormone imbalance.
• Endometrial hyperplasia.
• Polyp.
• Ketosis diet.
• Use of progestin only contraceptives.
• Use of intrauterine devices.
• Cervical cancer.
• Uterine fibroids.
• Enlarged uterus with dysmenorrhea.
• Occasionally during ovulation.
• Abortions.

Symptoms

• Slight to heavy bleeding between regular menstrual periods.
• Cramping abdominal pain with the bleeding.
  

Diagnosis

• Complete medical history.
• Menstrual history.
• Pelvic examination.
• Blood tests for thyroid and ovarian functions.
• Ultrasound scan.
• Sonohysterogram.

Keep track of the number of pads or tampons used over time so that the amount of bleeding can be determined. Uterine blood loss can be estimated by keeping track of how frequently a pad or tampon is soaked and how often one needs to be changed.

Treatment

It depends on the cause.

Treatment includes drugs to replace the hormones, antibiotics to cure infection. If the bleeding is due to intrauterine devices (IUD), the device may need to be removed. Polyps and other types of growths are treated with surgery. Cancer may be treated with combination of chemotherapy, radiation, or surgery. Women with bleeding due to abortions or tubal pregnancy need immediate medical treatment because both can cause serious complications if not treated. A procedure called Dilatation and curettage (D and C) might be performed to empty the uterus of any tissue remaining after miscarriage.

Prevention

• Maintain healthy weight. Women who are overweight or underweight have more problems with abnormal bleeding.
• If you are using birth control pills, be sure to take them as directed and at the same time every day.
• If you are taking hormone replacement therapy, take your pills as directed and at the same time every month.
• Learn to practice relaxation exercises to reduce and cope the stress.
• Bed rest may be recommended if the bleeding is heavy.
• Do not take aspirin while menstruating. Aspirin cause bleeding to occur longer and heavier.
  

When to seek medical professional help

• If abnormal bleeding returns.
• Bleeding increases or becomes severe enough to cause weakness or light headedness.
• Fever or pain in the lower abdomen develops.
• Symptoms do not improve within 2 months.
• Symptoms become more severe or more frequent.
  

What to do if you have bleeding between periods

• Bed rest recommended if bleeding is heavy.
• Avoid aspirin when bleeding occurs between periods.
• Record how often you change pads or tampons.