Many women will experience breakthrough bleeding during their menstrual years and for the most part, it’s not a cause for concern. However, it’s always a good idea to keep track of your monthly cycle and take note of anything that may signal a problem. Below, we break down what you need to know.

Common Causes

There is a whole host of things that can cause breakthrough bleeding, which refers to vaginal bleeding outside of your period. It can range from a few spots to something heavier that requires a pad or tampon.

Some of the most common causes for women who are not pregnant include:

• Starting or changing your hormonal birth control (this usually lasts a few cycles as your body adjusts)
• Using a low-dose birth control pill
• Missing doses of oral contraceptives, or experiencing persistent vomiting or diarrhea that interferes with the absorption of them
• Using an IUD (intrauterine device) for birth control, either with or without hormones
• A sensitive cervix, which may bleed after a vaginal exam, sex, or other irritations or injuries
• Ovulation, which sometimes causes the uterine lining to break down early; this can be accompanied by mild pain (called mittelschmerz)
• Perimenopause, which refers to the phase leading up to menopause when your cycle may start changing

Less commonly, you may experience breakthrough bleeding due to:

• Conception, which causes implantation bleeding in some women
• Sexually transmitted diseases (STDs), particularly chlamydia and gonorrhea
• Inflammatory conditions, such as endometriosis, pelvic inflammatory disease, vaginitis or cervicitis
• Benign growths on your reproductive organs, such as ovarian cysts, uterine fibroids or polyps and cervical polyps
• Gynecological cancer, including cervical, ovarian, uterine, vaginal or vulvar

When to See Your Provider‍

While breakthrough bleeding is a relatively common occurrence for many women, if it’s new for you, or if you have any concerns about its cause, you should make an appointment with your women’s health provider.

We also recommend you schedule an appointment if the bleeding is heavy or accompanied by other symptoms, such as:

·         Fever

·         Pain or pressure in your chest, abdomen, pelvis, back or legs

·         Frequent urination, a burning sensation while urinating or cloudy urine

·         Trouble emptying your bladder

·         Constipation

·         Vision changes

We always think it’s better to err on the side of caution, and we welcome the opportunity to address any concerns you have. Please don’t hesitate to call us to speak with a nurse or schedule an appointment.

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