Spotting between periods: what’s normal, what’s not?

For women with regular periods, a heavier menstrual cycle or spotting in between periods may not seem like a cause for concern. But if you’re experiencing abnormal bleeding, you need to alert your gynecologic health care provider about your symptoms—which could be indicative of illness, injury, or a more serious health issue.

Abnormal bleeding can range in severity from mild spotting between periods to heavy or prolonged blood flow and should always be evaluated by a doctor.

“Some women assume that spotting is a normal part of menstruation, but any bleeding between periods or heavier or prolonged flows should always raise a red flag, and you should alert your doctor regarding your symptoms,” says Dr. Sueny Seeney, OB/GYN at Riddle Hospital.

In most cases, abnormal bleeding is not a life-threatening issue. Instead, it can be a symptom of a variety of different illnesses, health conditions, or injuries. These can include polycystic ovarian syndrome, pelvic inflammatory disease, a sexually-transmitted disease or other vaginal infection, uterine fibroids, and even surprising factors like thyroid, liver, or kidney disease. Certain medications can also be a factor.

In more serious cases, abnormal bleeding can be indicative of cervical, endometrial, ovarian, or vaginal cancer.

Because the causes of abnormal bleeding can vary greatly, it’s important to contact your doctor as soon as you notice symptoms. To prepare for your appointment, come with as many details as possible.

“Abnormal bleeding can range from mild spotting to heavy bleeding, so provide as much information to your doctor as possible, including whether or not you’re experiencing other symptoms, like cramping, nausea, bladder or bowel changes, or significant changes in weight,” says Dr. Seeney.

A thorough history and pelvic examination are important. Further evaluation may include a Pap smear, blood tests, pelvic ultrasound, or tissue biopsy. Although abnormal bleeding should be regarded as a health concern for any woman, it’s especially concerning for women who are not menstruating, including young girls who have not yet begun getting their period, pregnant women, or women who are post-menopausal.

“In situations like these—when bleeding of any kind is not anticipated—it’s especially important to notify your doctor right away,” says Dr. Seeney.

If you’re experiencing spotting between periods, a heavier period than usual, prolonged bleeding, or have begun bleeding even though you are no longer getting regular periods after menopause, don’t delay in making an appointment.

Main Line Health gynecologists provide expertise in a wide range of services, including contraceptive services, care during perimenopause, and preventative care in the post-menopausal years. If you’re concerned about emotional changes during menopause, talk to your gynecologist. Visit our website for more information on coping with the challenges of menopause, or to find a Main Line Health gynecologist in your area.