Bleeding between menstrual cycles

Dr Maxwell Adeyemi

At some point in every woman’s life, she may experience bleeding in between her menstrual cycle. This symptom referred to as mid-cycle spotting or bleeding can be a source of great concern. Mid-cycle spotting is also known as abnormal uterine bleeding, inter menstrual bleeding, or metrorrhagia.

Menstrual period bleed is usually bright to dark red, heavier than just light spotting and lasts for about three to seven days. Bleeding from mid-cycle spotting is small in quantity, light pink, red, or even dark brown, lasting for as short as a few hours to one day.

Causes of mid-cycle spotting:

Spotting before ovulation

Before the mature egg is released, oestrogen levels drop and can cause the endometrium to shed and result in light spotting. The blood is typically pink or light-red and bleeding is light and lasts only a day or two. It is estimated that about five per cent of women experience mid-cycle spotting during ovulation – a time when the body undergoes rapid, complex hormonal changes. For these women, ovulation spotting is generally little cause for concern.

Spotting after ovulation

Spotting after ovulation may indicate “implantation bleeding” when a fertilised egg implants and attaches to the lining in the uterus. Implantation bleeding may occur around the time the menstrual cycle is expected to start, but there are a couple of noticeable differences. Unlike a regular period, blood clots or tissue will not be seen in the spotting.

Hormonal imbalances

The menstrual cycle is regulated by a complex network of hormones known as the hypothalamic-pituitary-ovarian (HPO) axis. Any disruption to your HPO caused by a resultant medical condition may trigger mid-cycle spotting.

Endometriosis

A disorder in which the tissue (endometrium) that lines the uterus is found growing elsewhere, endometriosis usually can cause pelvic pain associated with menstrual period, painful period, and mid-cycle spotting.

Polycystic ovary syndrome

A condition that affects mostly women of reproductive age. Women with polycystic ovaries have more male hormones (androgen). This can cause mid-cycle spotting, irregularities in menstrual cycle, and development of follicles that refuse to release eggs.

Thyroid disorder

Thyroid hormone stores and produces hormone that affect the function of virtually all the organ in the body. When there is a disorder in the thyroid function, whether it’s high or low thyroid hormone, disturbances in menstrual cycle are expected. It can cause either irregular period, spotting mid-cycle or even a prolonged menstrual flow.

Luteal phase defect

Luteal phase defect occurs when a person menstruates less than ten days after ovulation. This can result in low progesterone level which could lead to menstruating a lot sooner than expected.

Tumours in the reproductive system

Tumours, benign or malignant, can cause make the hormones to be unstable, resulting in bleeding when you are least expecting your menstrual flow.

Fibroids and polyps

Benign growths that form in the uterus such as uterine fibroid and polyps are more likely to cause irregular bleeding if they grow into the uterine lining or on the cervix.

Ovarian cyst rupture

A sharp pain on either side of your lower abdomen, followed by slight bleeding around the time you should be ovulating, or pain, nausea, vomiting, or bleeding from the vagina at any point in your cycle, is an indication that you have a ruptured ovarian cyst

Anovulation

Bleeding during ovulation is not an unusual thing. But when the cycle is anovulatory, it may trigger bleeding before menstruation as a result of a hormonal imbalance.

Sexual intercourse

The cervix becomes more sensitive around the time of ovulation because it is preparing for pregnancy. Sexual intercourse at this time may cause some slight bruising to the cervix, producing light, blood-tinged mucus.

Cervical cancer

Post-sex or post coital spotting may be a sign of cervical cancer. Malignant or cancerous growth of the cervix often presents with abnormal bleeding in females and should be investigated early for prompt diagnosis.

Cervicitis

Infection and inflammation of the cervix can also cause abnormal bleeding. Contact bleeding may be triggered from the cervix by sexual intercourse.

Sexually transmitted infections

In some rare cases, bleeding after intercourse can also signal a sexually transmitted infection (STI), such as chlamydia or gonorrhoea. Untreated STIs can also lead to pelvic inflammatory disease, which is another cause of mid-cycle spotting.

Birth control

Women taking hormonal contraceptives may be more likely to experience bleeding if they miss a pill, take one at a different time, or switch to a new medication. Intrauterine devices contain a progesterone-like hormone called levonorgestrel, which may cause mid-cycle bleeding in some women.

Excessive exercise

Exercise may cause changes in the hormone levels, which in turn affects the build-up and shedding of the uterine lining. The body may respond to these mixed hormonal signals by randomly shedding.

Poor nutrition

Unbalanced diets and excessive alcohol consumption can affect the production and normal functioning of hormones, causing irregular menstrual bleeding.

If you experience mid-cycle bleeding or spotting, it is wise to consult with your private physician or a gynaecologist.

Contact Dr Maxwell on 363-1807 or 757-5411.