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Have you heard of Breakthrough Bleeding?

breakthrough bleeding

Have you ever noticed in your sanitary napkin that you bleed without having your period and still missing several days for the next menstruation? Some women experience these slight losses of blood at specific times in their reproductive life. For others, the appearance of small brown spots or even similar to menstrual bleeding between periods is more common. It is called Breakthrough Bleeding.

Does bleeding between periods so frequent mean that we should consider it as something normal? we will try to explain it to you in detail.

It is a heavy period bleeding that comes from the uterus and is often caused by benign anatomical changes or hormonal alterations throughout the menstrual cycle without having to be associated with any problem.

tablets that can cause breakthrough bleeding

The 5 most frequent causes of bleeding between periods:

  • Ovulation
  • Undiagnosed pregnancy
  • Taking hormonal contraceptives
  • Fibroids or endometrial polyps
  • Stress

Bleeding before period due or between periods is not always considered an indicator of the existence of a serious health problem (hormonal imbalance, complications in pregnancy, uterine fibrosis, vaginal infection, or cancer). But this does not mean that it is normal. Some of the most common causes of intermenstrual bleeding are: taking contraceptives, hormonal changes around ovulation, polyps, or changes in the cervix. The important thing is to go to the doctor.

1. Ovulation: It is usually light menstrual bleeding for 3 days. Although it may be greater in duration and quantity and coincides, approximately, with the middle of the cycle in women who have regular periods. 

It is due to the peak of the secretion of the hormone related to ovulation. There are women to whom it happens quite regularly, even every month, and other women who will never suffer from it.

2. Undiagnosed pregnancy: It is likely that a woman who does not know that she is pregnant will discover it when going to the doctor for abnormal bleeding. 

side effects of birth control pills

This occurs due to the implantation of a fertilized egg in the uterus. Because implantation can occur up to two days before your period is due, it’s easy to get confused. In most cases, heavy period bleeding is scarce and subsides spontaneously or when resting, so the pregnancy continues its normal course. At other times it may indicate abortion or extrauterine pregnancy.

3. Taking hormonal contraceptives: When you start taking this type of hormonal preparations, it is quite common to have little bleeding between one period and another. 

They are usually short-lived, but there are also women who can bleed continuously. In most cases, it occurs during the first months of treatment and disappears later. Bleeding occurs more frequently at the start of IUD use but usually goes away.

4. Fibroids or endometrial polyps: Both can be located inside the uterine cavity and can cause atypical bleeding between periods as well as more abundant menstruation.

5. Stress: By maintaining high levels of stress hormones throughout the day, physical symptoms such as headaches, contractures, intestinal or heart problems, even a drop in the immune system can appear. Stress can also cause hormonal changes, alterations in the menstrual cycle, problems with sexual desire, and even the disappearance of menstruation.

breakthrough bleeding


Steps to follow in the case of bleeding between periods:

It is important to make sure that the bleeding is coming from the vagina and not from the rectum or urine, as its causes vary completely. It can be checked by inserting a tampon into the vagina to confirm whether the source of bleeding in the vagina, cervix, or uterus.

If the breakthrough bleeding is more abundant than your period and you also have sweating, dizziness, or tachycardia, you should go to the emergency room. We must also go to the hospital service when it has an intense red, brown, or almost black color.

In most cases, a gynecological examination is the best way to find the source of the bleeding. The gynecologist will determine if the blood is coming from the vagina, the cervix, or the uterus and will perform the differential diagnosis. 

To do this, he or she will complete your medical history and, in most cases, will indicate an ultrasound and cytology. This test can be done even while the bleeding is occurring.

The gynecologist may indicate other types of tests to reach the diagnosis: cervical cultures to rule out sexually transmitted diseases or STDs, blood tests to assess thyroid and ovarian function (hormones), or endometrial biopsy.

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