Christie Clinic - Medicine for Your Life

Our website is currently having technical difficulties. To view the site, please click here

Health Encyclopedia

Health Encyclopedia

An invaluable resource of health information.

Vaginal bleeding between periods

Intermenstrual bleeding is bleeding from the uterus that occurs between menstrual periods.

  • Alternative Names

    Bleeding between periods; Intermenstrual bleeding; Spotting; Metrorrhagia

  • Considerations

    Normal menstrual flow lasts about 4 days, produces a total blood loss of 30 to 80 ml (about 2 to 8 tablespoons), and occurs normally every 28 days (plus or minus 7 days).

    Vaginal bleeding that occurs between periods or after menopause sometimes may be due to cancer or precancer, and should be evaluated promptly. The risk of cancer increases with age.

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

    A careful exam by your health care provider is frequently the best way to sort out the source of the bleeding. This exam can be accomplished even while you are bleeding. Do not delay getting an exam just because you are currently bleeding.

  • Common Causes
    • Cancer of the cervix, uterus, or (very rarely) fallopian tube
    • Cervical or endometrial biopsy or other procedures
    • Changes in hormone levels
    • Injury or disease of the vaginal opening (caused by intercourse, infection, polyp, genital warts, ulcer, or varicose veins)
    • IUD use (may cause occasional spotting)
    • Ectopic pregnancy
    • Miscarriage
    • Other pregnancy complications
    • Uterine fibroids or polyps
    • Vaginal dryness due to lack of estrogen after menopause
    • Stress
    • Stopping and starting birth control pills or estrogens
    • Underactive thyroid (low thyroid function)
    • Use of blood thinners (anticoagulants)
  • Home Care

    Immediately contact a health care provider if bleeding is very heavy.

    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.

    Because aspirin may prolong bleeding, it should be avoided, if possible.

  • Call your health care provider if

    Call your health care provider if:

    • You are pregnant
    • There is any unexplained bleeding between periods
    • There is any bleeding after menopause
    • Abnormal bleeding is accompanied by other symptoms
  • What to expect at your health care provider's office

    The doctor will peform a physical exam and ask questions about your medical history. The physical examination with include an emphasis on the pelvic area.

    Questions may include:

    • Time pattern
      • When did this bleeding between periods begin?
      • Does it occur consistently, such as every month?
      • When (during the course of a menstrual cycle) does this bleeding begin?
      • How long does the in-between bleeding last?
    • Quality
      • Is the bleeding heavy?
      • How many tampons or pads are required?
      • Do cramps accompany the bleeding?
    • Aggravating factors
      • What makes it worse?
      • Does increased physical activity make the bleeding worse?
      • Does intercourse bring on the bleeding?
      • Is increased stress associated with the bleeding?
    • Relieving factors
      • Does anything relieve or prevent it?
    • Other symptoms
      • What other symptoms do you have?
      • Do you have abdominal pain or cramps?
      • Is there increased bruising elsewhere on the body?
      • Do you have any difficulty, pain, or burning with urination?
      • Is there bloody urine or blood in the stools?
    • Other important information
      • Are you pregnant?
      • Have you had a miscarriage or abortion?
      • Have you had a D and C?
      • Have you ever had an abnormal Pap smear?
      • What medications are you taking? Do you take hormones or supplements?
      • Are you using tampons? What kind? What size?
      • At what age did your periods start?
      • Have you had normal periods without bleeding between in the past?
      • Are you sexually active?
      • Do you have a history of sexually transmitted disease?
      • Are you using birth control? What kind?
      • Have you been injured?
      • Have you received any medical or surgical treatments?

    Tests that may be done include:

    • Blood tests for thyroid and ovarian functions
    • Cervical cultures for sexually transmitted diseases
    • Colposcopy
    • Endometrial biopsy
    • Pap smear
    • Pelvic ultrasound
    • Pregnancy test
  • References

    Lobo RA. Abnormal uterine bleeding: ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, PA: Mosby Elsevier; 2007:chap. 37.

    Casablanca Y. Management of dysfunctional uterine bleeding. Obstet Gynecol Clin North Am. 2008;35(2):219-234.

Review Date: 6/26/2008

Reviewed By: Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2014 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
Christie Clinic Christie Clinic on University Photo Christie Clinic on University
101 West University Avenue Champaign, IL 61820 Main Phone: (217) 366-1200
Billing Services: (217) 366-1382
Toll Free: (888) 391-0412
Christie Clinic Christie Clinic on Windsor/Convenient Care Photo Christie Clinic on Windsor/Convenient Care
1801 West Windsor Road Champaign, IL 61822 (217) 366-8000
Christie Clinic Christie Clinic at Presence Covenant Photo Christie Clinic at Presence Covenant
1400 West Park Street Urbana, IL 61801 (217) 366-1200
Christie Clinic Christie Clinic in Rantoul Photo Christie Clinic in Rantoul
209 West Borman Drive Rantoul, IL 61866 (217) 892-9671
Christie Clinic Christie Clinic in Mahomet/Convenient Care Photo Christie Clinic in Mahomet/Convenient Care
1001 Commercial Drive Mahomet, IL 61853 (217) 586-6600 or (217)366-8130
Christie Clinic Christie Clinic in Danville on Vermilion/Convenient Care Photo Christie Clinic in Danville on Vermilion/Convenient Care
3545 North Vermilion Street Danville, IL 61832 (217) 442-8611
Christie Clinic Christie Clinic in Tuscola Photo Christie Clinic in Tuscola
300 North Main Street Tuscola, IL 61953 (217) 253-9258
Christie Clinic CU Sleep Photo CU Sleep
1207 South Mattis Avenue Champaign, IL 61821 (217) 355-1684
Christie Clinic Christie Clinic Cancer Center Photo Christie Clinic Cancer Center
109 West University Avenue Champaign, IL 61820 (217) 366-5180
Christie Clinic Convenient Care in County Market (Kirby & Duncan) Photo Convenient Care in County Market (Kirby & Duncan)
2901 West Kirby Avenue Champaign, IL 61821 (217) 366-8130
Christie Clinic Christie Clinic in Urbana/Convenient Care Photo Christie Clinic in Urbana/Convenient Care
1710 East Windsor Road Urbana, IL 61802 (217) 344-9440
Christie Clinic Christie Clinic in Danville on Logan Photo Christie Clinic in Danville on Logan
800 North Logan Avenue Danville, IL 61832 (217) 431-8930
Christie Clinic Christie Clinic on Fox Drive Photo Christie Clinic on Fox Drive
2110 Fox Drive, Suite B Champaign, IL 61820
Christie Clinic Kirby Medical Group Specialty Clinic in Monticello Photo Kirby Medical Group Specialty Clinic in Monticello
1109 A. North State Street Monticello, IL 61856 (217) 366-1304
Gibson Area Hospital
1120 N Melvin Gibson City, IL 60936 (217) 784-2240
Christie Clinic Christie Clinic in Mattoon Photo Christie Clinic in Mattoon
105 B Professional Plaza Mattoon, IL 61938 (217) 345-3000
Christie Clinic Sarah Bush Lincoln Health System Photo Sarah Bush Lincoln Health System
1000 Health Center Drive Mattoon, IL 61938 (217) 258-2588
Christie Clinic The Champaign SurgiCenter Photo The Champaign SurgiCenter
1702 S. Mattis Avenue Champaign, IL 61821 (217) 326-2030
Christie Clinic The Carle Foundation Hospital Photo The Carle Foundation Hospital
611 West Park Street Urbana, IL 61801 (217) 383-3311
Iroquois Memorial Hospital
200 E. Fairman Ave. Watseka, IL 60970 (815) 432-5841
Christie Clinic Christie Clinic at Savoy Photo Christie Clinic at Savoy
501 North Dunlap Avenue Savoy, IL 61874 Transformations: (217) 366-7460 Internal Medicine: (217) 366-5434 Ophthalmology: (217) 366-1250
Christie Clinic at 410 E. University
410 E. University Champaign, IL 61820
Christie Clinic on West Park Street
1405 West Park Street Urbana, IL 61801 217-366-1237
Christie Clinic in Monticello
107 West Main Street Monticello, IL 61856 217.762.3352