Abnormal Vaginal Bleeding Between Menstrual Periods: What You Need to Know

Any vaginal bleeding that occurs during a time when you aren’t on your menstrual period is considered abnormal. Fortunately, irregular vaginal bleeding, also known as uterine bleeding, can often be easily treated. However, this spotting could also be a sign of a more serious condition, like fibroids, an infection, or polyps. Learn more about the causes and treatment of abnormal vaginal bleeding.

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An Overview of Irregular Vaginal Bleeding

How much you bleed, when your period starts, and for how long it lasts is unique to you. The average menstrual cycle lasts 28 days but for most people with a uterus, it can range between 21 to 35 days.

Bleeding in any of the following situations is considered abnormal uterine bleeding:

Prevalence of Irregular Vaginal Bleeding

The prevalence of abnormal uterine bleeding among reproductive-aged people internationally is estimated to be between 3% to 30%, with a higher incidence occurring around menarche (first period) and perimenopause. Many people do not seek treatment for their symptoms, making exact prevalence difficult to determine.

Causes of Abnormal Bleeding

There are many different causes of bleeding between periods. Some may not be anything to worry about, but seek medical advice if you're concerned.

Birth Control

You may experience abnormal or unexpected bleeding if you start or stop using a form of hormonal birth control, such as the pill.

If you’re on the pill and are late taking your medication or forget a tablet, you may have some spotting. Additionally, if you have an intrauterine device (IUD) fitted this can also increase your chance of abnormal bleeding between periods.

Stress and Lifestyle Changes

Stress and lifestyle changes, such as gaining or losing weight, dieting, changing exercise routines, traveling, illness, and other disruptions to your normal daily routine can impact your menstrual cycle and cause irregularities.

Menarche and Menopause

When a person first starts their menstrual cycle (menarche), it is common for cycles to be erratic. This can include spotting at various times throughout the cycle. Usually, this resolves as adolescence progresses and hormones stabilize.

This type of unpredictable bleeding may also happen when you begin to transition into menopause. As you get closer to menopause, your periods might be harder to predict and irregular bleeding is common.

Structural Abnormalities

Uterine fibroids are a common type of benign (noncancerous) tumor that can grow in and on your uterus. Not all fibroids cause symptoms, but when they do, symptoms can include heavy menstrual bleeding, bleeding between periods, back pain, frequent urination, and pain during sex. 

Endometrial polyps, also called uterine polyps are usually small, bulb-shaped masses of endometrial tissue attached to the uterus by a stalk. Symptoms may include heavy menstrual bleeding, spotting between periods, bleeding after intercourse, and bleeding after menopause.

Polycystic Ovary Syndrome (PCOS)

If you have PCOS, your ovaries don’t release eggs the way they should. Your body also makes too many male hormones (called androgens). This can lead to irregular periods, spotting, and sometimes no period at all.

Pregnancy

You may experience a small amount of bleeding in early pregnancy, called implantation bleeding. Bleeding between menstrual periods is one early sign of a miscarriage. Miscarriages can occur at any time during pregnancy and may happen before you even know you are pregnant.

Cancers of the Reproductive System

In most cases, bleeding between periods is not a cause for concern. However, vaginal bleeding between periods is one possible symptom of certain types of cancer. It is especially important to take note of abnormal vaginal bleeding if you have entered menopause.

The following cancers may cause irregular vaginal bleeding:

Could Abnormal Vaginal Bleeding Be a Sign of Cancer?

About 90% of people with endometrial cancer have abnormal vaginal bleeding. Noncancer conditions can also cause abnormal bleeding but it's important to have a healthcare provider check out any irregular bleeding right away.

Other causes of abnormal vaginal bleeding include:

  • Endometriosis or adenomyosis can cause bleeding or spotting between periods. These conditions may also cause heavy or painful menstrual periods and cramps between periods.
  • Sexually transmitted infections (STIs) can cause irregular vaginal bleeding. Chlamydia can cause bleeding during or after sex as well as bleeding between periods.
  • Infection of any of the pelvic organs can lead to abnormal bleeding, including conditions like bacterial vaginosis and pelvic inflammatory disease (PID).
  • Blood clotting disorders, like von Willebrand disease, may cause periods that last longer than eight days.
  • Other health conditions, like hypothyroidism, may also affect periods.

When to Seek Medical Attention

You should see your doctor if you are experiencing the following:

  • Bleeding that requires more than one tampon or sanitary pad in an hour, for several hours in a row
  • Bleeding or spotting between periods
  • Bleeding during or after having sex
  • Severe pain
  • Fever
  • Abnormal discharge or color
  • Unexplained weight gain or loss

It’s important to track when the bleeding is happening and any other symptoms to share with your clinician. Being aware of any other symptoms related to spotting between periods can help a doctor to diagnose an underlying medical issue.

When To Seek Urgent Help

You should see a doctor urgently for your menstrual bleeding if:

  • You are pregnant
  • Heavy bleeding lasts for more than 24 hours
  • You are postmenopausal

Treatment for Vaginal Bleeding

Treatment for irregular vaginal bleeding depends on the underlying cause. Sometimes, all that is needed is to rule out cancer and determine whether irregular vaginal bleeding bothers you enough to warrant medication or treatment.

Medication

Medications often are tried first to treat irregular or heavy menstrual bleeding. These include the following:

  • Hormonal birth control methods: These can help make periods more regular.
  • Gonadotropin-releasing hormone (GnRH) agonists: These drugs can stop the menstrual cycle and reduce the size of fibroids.
  • Tranexamic acid: This medication treats heavy menstrual bleeding.
  • Nonsteroidal anti-inflammatory drugs: These drugs, which include ibuprofen, may help control heavy bleeding and relieve menstrual cramps.
  • Antibiotics: If you have an infection, you may be given an antibiotic.
  • Special medications: If you have a bleeding disorder or thyroid issue, your treatment may include medication to treat these conditions.

Surgery

If medication does not reduce your bleeding, a surgical procedure may be needed. There are different types of surgery depending on your condition, your age, and whether you want to have children.

  • Endometrial ablation destroys the lining of the uterus. It stops or reduces the total amount of bleeding.
  • Uterine artery embolization is a procedure used to treat fibroids by blocking the blood vessels to the uterus, which in turn stops the blood flow that fibroids need to grow.
  • Hysterectomy, the surgical removal of the uterus, is used to treat some conditions or when other treatments have failed. Hysterectomy also is used to treat endometrial cancer.

Frequently Asked Questions

Can you experience vaginal bleeding for a month?

Typically, a period lasts between three to seven days. A menstrual period that lasts longer than seven days is considered a long period. It’s important to speak to your doctor or gynecologist if you experience a period that lasts longer than a week.

Is it normal to have vaginal bleeding with clots?

It's perfectly normal to notice some clots from time to time during your period. As the uterus sheds its lining, this tissue leaves the body as a natural part of the menstrual cycle. Generally speaking, if the clots are smaller than a quarter and there is not a lot of them, you shouldn't worry.

Is there a way to stop abnormal vaginal bleeding naturally?

Taking vitamin supplements might help with bleeding but more research needs to be carried out in this area. Check with your doctor before taking any supplements. They can determine whether you actually need a supplement, the appropriate dose, and side effects or interactions to watch for.

A Word From Verywell

Abnormal uterine bleeding can be worrying but is often treatable. Keep a diary of any unusual bleeding patterns and note any other symptoms.

If you experience irregular vaginal bleeding, speak to your doctor about what may be causing the issues and the treatments available. In some cases, the condition may be temporary and respond to changes in your lifestyle.

If you are bleeding and postmenopausal, this needs to be investigated as a matter of priority to rule out a reproductive system cancer.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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