Possible causes of bleeding after menstruation and in the middle of the cycle. Causes of bleeding in women between periods

Bloody discharge in the middle of the cycle is a reason to consult a gynecologist. Since during the intermenstrual period only light mucous discharge from the vagina is allowed, protecting the internal genital organs from penetration pathogenic microorganisms.

Having studied more than one medical forum, we noticed that most women face this problem. Therefore, in this topic we want to tell you why there are bleeding in the middle of the cycle, when they are considered normal, and when they are an alarming signal and should not be ignored.

Intermenstrual bleeding: normal or pathological

Scanty bleeding of brown or dark red color during the intermenstrual phase can appear in practically healthy representatives of the fair sex. When does this happen? Let's consider the situations.

• 3-4 days before the onset of menstruation, a woman may experience spotting, which is a sign of approaching menstruation.
• The first 1-2 days after critical days a small bloody discharge may also be present as the uterus gets rid of the remaining menstrual blood.
• In women taking oral hormonal contraceptives, on the 14-15th day of the cycle, minor brown discharge.
• After sex, if a woman long time there was no intimate relationship and the Bartholin glands did not secrete enough mucus; a little blood may be released due to microtrauma of the mucous epithelium of the vagina.
• After the first sexual intercourse, when the hymen ruptures, the girl may experience bleeding for some time after intimacy.

In all other cases, the appearance of blood between periods is considered a pathology. A sign of the disease may be a combination of bloody discharge with pain in the lower abdomen, fever, itching in the vagina, pain during and after sex.

You should also visit a specialist if you are constantly bothered by brown, dark or bloody discharge after sex.

In premenopause, liquid brown spotting bothers women due to hormonal disorders, which is a natural process of aging of the female body. Such bleeding most often appears against the background of a failure in the timing of ovulation, as a result of which the cycle changes. Most often, bleeding occurs in women after long delay menstruation, and can recur over several weeks.

In addition to the above, brown or bloody discharge in women who have been in menopause for more than a year may indicate pathology.

The appearance of intermenstrual metrorrhagia (bleeding) is due to both physiological and pathological reasons.

Light bleeding between periods is considered normal, without inflammatory symptoms(unpleasant odor, itching, abdominal pain, lower back pain).

TO physiological reasons The following factors can be considered:

• an increase in the level of lutein-stimulating hormone (LH) and estrogen, which are responsible for the release of the egg from the ovary. Therefore, bloody discharge may be a sign of the egg’s readiness to “reproduce”;
• too active sexual pleasures, inappropriate position during sexual intercourse, or the partner’s genital organ is too large, as a result of which the cervix and vaginal mucosa are injured. If such discharge is observed constantly after sex, it is necessary to consult a gynecologist, since sometimes this is the first and only manifestation of pathologies such as cervical cancer, vaginal neoplasms, and;
• Brown or bloody discharge in the middle of the cycle is a sign of pregnancy. During the attachment of a fertilized egg to the endometrium, some women secrete a small amount of bloody fluid. Metrorrhagia at other stages of pregnancy is an alarming signal and requires immediate attention. medical care, as they may be the first sign of miscarriage, premature birth, placental abruption, etc.

Normally, such discharge becomes noticeable only during washing or other hygiene procedures, that is, they should not stain their underwear.

If intermenstrual discharge of any nature is too heavy, you must consult a gynecologist for comprehensive examination body, as this may be the first sign of many diseases of the genital and other organs.

Also, the appearance of discharge during the intermenstrual period often indicates the presence of diseases. Let's look at them.

• Inflammation of the endometrium. This pathology is characterized by inflammation of the inner layer of the uterus, which develops due to the penetration of pathogenic microorganisms into the uterus. Endometrial infection can occur during medical manipulations on the uterus (curettage, vacuum extraction ovum, probing of the uterine cavity, etc.) if they were performed without observing sanitary and epidemiological standards. In addition, endometritis may appear after childbirth. The discharge can be either bloody or purulent in nature with foul odor or be with mucus. The patient is also concerned about increased body temperature, pain in the lower abdomen, general weakness, chills, and increased sweating.
• Endometrial polyps. The occurrence of polyps is facilitated by curettage of the uterine cavity and cesarean section.
• Incorrectly selected doses of hormonal contraceptives. Inadequate dose of hormonal contraception can cause hormonal imbalance in the body, and this, in turn, causes metrorrhagia.
• Infectious processes in the vagina and cervix. The presence of inflammation inside the vagina and cervix can become an obstacle to the release of menstrual blood, which will continue to be released even during the menstrual period.
• Hormonal disbalance. The menstrual cycle is regulated by sex hormones. Each phase of the cycle is characterized by its own hormone, so if there is a hormonal imbalance, menstruation can occur even in the middle of the cycle.
• Endometriosis. This disease is characterized by the appearance of endometrial foci in places where it should not be - the cervix, vaginal walls, external genitalia, etc.
• Facilities intrauterine contraception(spirals). This contraceptive increases the risk of endometrial inflammation, and, accordingly, the appearance of spotting during the intermenstrual period.
• Benign and malignant neoplasms uterine walls(uterine fibroids and fibroids, cancer of the uterus and its cervix).
• Psycho-emotional shock. Severe stress can affect a woman’s hormonal background, causing it to malfunction. In addition, stress can exacerbate chronic diseases organs of the reproductive system, which will become a provoking factor between menstrual bleeding.

Regular examinations with a gynecologist are effective measure prevention of diseases of the female genital organs. Every healthy woman should visit this specialist Twice a year.

If there is regular and prolonged intermenstrual bleeding, the gynecologist will definitely prescribe a series of studies that will help determine the cause of the menstrual irregularity.

The following methods can be used in the diagnosis of menstrual disorders:

• gynecological examination of the vagina and cervix using speculum;
• colposcopy - examination of the cervix using a special device - a colposcope;
• vaginal smear for microflora;
• cervical smear for cytological examination;
• general clinical blood test;
• blood test for sex hormonal panel;
• blood test for the Wasserman reaction (detection of antibodies to the causative agent of syphilis);
• tissue sampling for histological examination;
• ultrasound examination of the pelvic organs, including transvaginal or transrectal;
• blood test for HIV;
• diagnostic curettage of the uterine cavity with further histological analysis material and others.

Thus, only an experienced specialist - a gynecologist - can correctly determine the cause of intermenstrual bleeding. In this case, we do not recommend engaging in self-diagnosis and self-medication, since such amateur activities can lead to irreversible consequences for health. After all, the choice of treatment method directly depends on the causative factor.

Let us remind you once again that every healthy woman should visit a gynecologist for preventive examination every six months.

Light spotting outside of menstruation or bleeding between periods is quite common. They occur in many women. Bloody discharge usually occurs before menstruation or a few days after it ends. However, they can appear on any day in the middle of the cycle. Most often, the nature of such discharge is normal and is not considered a symptom of any serious disease. But the causeless occurrence of profuse bleeding may be a sign of diseases of the uterus and other disorders of the female genital organs.

It is worth pointing out that the normal duration of the menstrual cycle is from 21 to 35 days, the duration of menstrual bleeding is 3-7 days, and blood loss ranges from 40 to 80 ml. Monthly blood loss of more than 50-60 ml contributes to the occurrence of acute shortage iron in female body.

Causes of bleeding in the middle of the cycle.
Intermenstrual bleeding refers to uterine or vaginal bleeding that occurs between menstruation, earlier or later than the expected start of menstruation. This phenomenon Also known as vaginal bleeding between periods, it occurs as the discharge of blood clots in the middle of the menstrual cycle. Some women attribute this phenomenon to a short cycle, but this is not true at all. Short cycle(polymenorrhea) involves severe blood loss that occurs on the 13th or 15th day after the end of the last menstruation. Such a phenomenon as polymenorrhea is usually observed in the disorder uterine contractions in conditions of slow regeneration of the mucous membrane of its cavity, as well as blood clotting disorders. Therefore, this kind of phenomenon does not apply to polymenorrhea.

Intermenstrual bleeding most often occurs 10-16 days after the end of the last menstruation. This type of bleeding is not profuse (that is, you can get by with using “daily pills”) and lasts on average from twelve to seventy-two hours. If the intensity of bleeding does not change, then there is no reason to worry. If blood loss increases, and the duration of bleeding is more than three days, you need to visit a gynecologist. In case of severe bleeding, you should call an ambulance. It also happens that, having already become pregnant, a woman has her last menstruation, and she has absolutely no idea about conception. Therefore, in cases where such bleeding is accompanied severe pain, there is a suspicion of an ectopic pregnancy, miscarriage, etc.

Intermenstrual bleeding is observed in almost thirty percent of women and is normal. This phenomenon is caused by fluctuations in estrogen levels during ovulation, which cause the endometrium to weaken and bleeding occurs. Most often in this situation, a woman is prescribed hormonal agents with estrogen to normalize hormone levels. Bleeding in the middle of the cycle is observed in women with frequent violations functions genitourinary system, while the nature of the bleeding is more intense.

There are two main types of bleeding that occur between periods:

• bleeding between two menstruation - intermenstrual bleeding;
• metrorrhagia - severe uterine bleeding.

• hormonal changes or disturbances in the body;
• insufficient hormones thyroid gland;
• miscarriage;
• diseases of the endometrium of the uterine cavity;
• use of intrauterine contraception (IUD);
• starting or stopping birth control pills;
• starting or stopping estrogen-based medications;
• severe depression or stress;
• cervical diseases;
• carrying out certain gynecological procedures (in particular cauterization and cervical biopsy);
• taking certain medications;
• vaginal infections or trauma to the vagina;
• benign neoplasms in the cervix, vagina or urethra.

In cases of intermenstrual bleeding, it is recommended to rest more and avoid stressful situations And depressive states. Therapy of this type bleeding is necessary if this phenomenon causes painful sensations in women, and is also caused by the development of serious diseases. In these cases, appropriate treatment is prescribed.

To prevent the development of serious diseases, it is very important to visit a gynecologist if there is a constant delay in menstruation, if painful menstruation, with heavy or scanty bleeding during menstruation, if their duration is violated. There is no need to despair if any pathology was identified during diagnosis, because treatment of the disease is based on early stage is quite effective.

Bloody discharge in the middle of the cycle.
Bloody discharge that is scanty in nature (basically there is no need to use pads) occurs much more often than intermenstrual bleeding. They are expressed in the form of mucus of a pinkish or light cinnamon hue from the vagina, which can only be noticed on toilet paper. Underwear does not get dirty.

This kind of discharge is observed approximately two weeks before the onset of menstruation and is absolutely normal occurrence. Basically, this period occurs during ovulation, so the discharge indicates the egg’s readiness for fertilization. Such selections help to determine as accurately as possible

Have you noticed unusual intermenstrual discharge? Find out why bleeding occurs in the middle of your cycle and whether you should worry.

The appearance of spotting in the middle of the menstrual cycle is a fairly common occurrence. It can be either a normal variant or a symptom of a disease. Why does bleeding occur in the middle of the cycle, and when does a woman need to sound the alarm?

Causes of “unscheduled” bleeding

Typically, such spotting appears during the period of expected ovulation - on days 10-16 of the cycle. They are barely noticeable and stop after 1-3 days. In most cases, their appearance is associated with a small hormonal imbalance and is not dangerous to a woman’s health.

A slight discharge of blood during this period, which does not stain the laundry and is detected when visiting the toilet, is most likely a sign of ovulation. The release of an egg from the ovary may be accompanied by a decrease in the content of the hormone estrogen in the body and weakening of the endometrium.

Such discharge does not require treatment. But if they cause discomfort, then medications may be prescribed to normalize them. hormonal levels.

Other causes of “unscheduled” bleeding include:

• Wrong reception oral contraceptives(for example, skipping several tablets in a row)
• Installation intrauterine device
• Carrying out a number of gynecological procedures (for example, cauterization or conization of the cervix)
• Decreased thyroid hormone levels
• Taking certain medications
• Inflammatory process or pathologies of the pelvic organs, vaginal trauma
• Spontaneous termination of pregnancy (miscarriage)
• Constant stress
• , presence of neoplasms and others serious illnesses reproductive system

Girls and women often experience intermenstrual bleeding during hormonal changes. This phenomenon is often observed in youth, when the cycle is not yet regular, and in women in the period preceding menopause.

The appearance of bleeding after sexual intercourse may indicate that the mucous membrane or cervix was damaged during sex. If this is observed repeatedly, the woman needs to visit a gynecologist.

Mid-cycle uterine bleeding may be a symptom dangerous diseases reproductive system.

Reader Questions

I have a problem, at the hour of ovulation I have been experiencing a strong cramping pain on my left side for several months in a row, and today I started seeing a white color with small blood clots. Why does the pain occur? 18 October 2013, 17:25 I have a problem, at the hour of ovulation, I have been experiencing a strong cramping pain on my left side for several months in a row, and today I started seeing a white color with small blood clots. What causes the pain? Should I wiggle through the vision?

When to worry

Minor discharge that accompanies ovulation and passes quickly is usually not a cause for concern. Since stress hormones suppress estrogen production, it is recommended to avoid stress and get plenty of rest. But at your next scheduled visit to the gynecologist, be sure to inform the doctor about this phenomenon.

If the bleeding intensifies, is accompanied by pain, or does not stop after 2-3 days, you should immediately consult a gynecologist. The doctor will determine exactly why bleeding occurs in the middle of the cycle and prescribe the correct treatment.

If the woman’s condition worsens and the bleeding becomes severe, you need to call ambulance. These symptoms indicate serious problems, many of which require urgent surgical intervention.

What will the treatment be like?

In most cases, prolonged and painful bleeding in the middle of the cycle is due to the presence of sexually transmitted infections. Based on the test results, the doctor will prescribe the patient antibacterial drugs and means local application (vaginal suppositories, ointments).

If tests, including testing for hidden infections, did not reveal the presence of pathogens, then they are looking for non-infectious causes of bleeding.

One of the diagnostic methods is condition analysis hormonal balance. This problem needs to be solved comprehensively, since when hormonal levels are disrupted, various internal organs. By correcting the functioning of the organ that caused the malfunction, you can solve the problem of bleeding.

Light pinkish discharge most likely indicates minor damage received during sexual intercourse. In these cases, the patient requires complete sexual rest for a certain time.

Extensive uterine bleeding(metrorrhagia) most often indicate the presence of the following diseases:

• endometriosis
• cervical erosion
• myoma
• cervical cancer
• chorionepithelioma

In most cases, surgery is required to treat these diseases.

Menstrual bleeding in healthy woman happens according to a strict schedule. Its volume is strictly determined so that the body does not experience severe consequences blood loss. But sometimes there is discharge in the middle of the cycle. What diseases are they associated with, and can this be considered a normal variant?

Within a month, a woman reproductive age In addition to menstruation, physiological leucorrhoea may be observed, the volume of which does not exceed 20 ml per day. They consist of the mucous secretion of the cervix, a small amount of lactic acid, hydrogen peroxide produced normal microflora, and dead cells, bacteria. Almost colorless, more like mucus, sometimes with a white tint. The smell may be a little sour, but not pronounced.

Changes in color and volume of natural leucorrhoea can occur on the eve of ovulation. They become more abundant, slimy, and whitish. But the appearance of brown streaks, blood, unpleasant odor- alarm signal.

Standard options

If brown discharge appears in the middle of the cycle (even without pain or odor), then this should alert you and force you to pay attention to the events preceding it. There are some situations in which such manifestations can be considered normal.

Breakthrough bleeding

The most common cause of non-pathological intermenstrual bleeding is ovulation. During the first phase of the cycle, under the influence of the pituitary FSH hormones(follicle-stimulating) and a little LH (luteinizing) the follicle matures. In particular, the number of vessels that feed it increases. They can entwine the entire surface of the bubble like a net.

By days 10-12 of the cycle, estrogen secretion reaches its peak level. After 12 hours, a response peak release of luteinizing and follicle-stimulating hormones occurs. This means that after 24-48 hours you can expect ovulation and, accordingly, intermenstrual bleeding. It occurs as a result of follicle rupture and vascular damage, and is therefore called breakthrough.

The discharge is not abundant, and its color ranges from light pink to dark. The application lasts one to two days and does not require a special pad (daily application is sufficient). In this case, treatment is not carried out.

Implantation

Dark “unscheduled” discharge may indicate pregnancy. If a woman's menstrual cycle is prolonged or not always regular, she may miss the moment of ovulation. Typically, the embryo travels from the ovaries to the uterine cavity in seven to ten days. Normally, implantation should occur at the peak of progesterone - this is the seventh day after ovulation. If a woman early ovulation, then the moment of attachment to the uterus will also shift.

During implantation, the embryo secretes enzymes that melt the endometrium along with the vessels in it. The embryo gradually sinks into the tissues and is covered with them. Some blood may leak from the melted vessels and be released through the vagina. The quantity is scant, there is no odor, the color is usually dark.

Consequences of contraception

When taking most combined oral contraceptives (COCs), spotting may occur mid-cycle during the first three months. The reason is the lack of gestagens in the drug. The following factors also influence:

• smoking;
• unstable hormonal levels;
• missed pill;
• violation of the instructions for the drug;
• inappropriate type of COC;
• low doses of hormones;
• concomitant gynecological pathology.

If bleeding has not disappeared in the fourth month of using the drug, you need to finish the plate to the end and consult a doctor to select another remedy. At heavy bleeding, the formation of jelly-like clots requires an urgent examination by a gynecologist.

Formation of the cycle

In adolescents, menstruation does not always become regular immediately after menarche. This takes up to a year. The concentrations and rhythm of secretion of LH and FSH in girls are often confused, so bleeding may occur between menstruation. If they are spreadable, without pain and odor, then there is nothing to worry about. But with constantly repeated bloody discharge, heavy bleeding you need to see a doctor urgently.

Spotting discharge occurs in nursing women when the menstrual cycle is just beginning to recover after pregnancy.

Consequence of pathology

Vaginal discharge may take on more than just a brown tint. Sometimes it all starts with the appearance of atypical leucorrhoea: it is accompanied by itching, becomes cheesy, thick, sour smell intensifies. Most likely, this is a sign of thrush. If left untreated, the inflamed mucous membrane will begin to bleed a little and pink impurities will appear.

But the reason may also be a sexually transmitted infection. If the discharge is watery, copious, and there is pain in the abdomen, then this is inflammatory process. A yellow tint usually indicates a nonspecific process, and a greenish tint usually indicates Trichomonas.

Pathological bleeding can be suspected if the following symptoms appear:

• copious discharge;
• the appearance of blood clots;
• sharp pain in the abdomen;
• nausea;
• temperature increase;
• unpleasant odor;
• prolonged metrorrhagia;
• scanty menstruation.

Endometriosis and endometrial hyperplasia

Pathological growth of the endometrium in atypical places leads to hormonal imbalance. This tissue has its own hormonal activity and can change the general background. In turn, excessive high level estrogen leads to endometrial hyperplasia. It can be diffuse and local, in the form of a pedunculated polyp. The thickened endometrium is capable of shedding, which leads to the appearance of metrorrhagia. In this case, for a woman of reproductive age, therapeutic and diagnostic procedure At the same time, curettage begins.

Sometimes endometrioid lesions in the uterine cavity are emptied, which can grow deep into the muscles. They empty themselves without a clear connection with menstrual cycle, the blood is almost black.

Myoma

Overgrowth of muscle and fibrous tissue leads to the appearance of lesions, which, if large in size or located under the mucous membrane, can disrupt the rejection of the endometrium. This happens regardless of the day of the cycle. It also manifests itself in the form of prolonged menstruation, which at first subsided and then intensified.

Fibroids can lead to heavy intermenstrual bleeding, and a woman develops anemia. The only method Treatment in such a situation is removal of the uterus.

Pathology of the cervix

The discharge of blood from the cervix during erosion is often of a contact nature. It appears after sexual intercourse or a doctor's examination. Sometimes brown discharge -
consequence of cauterization of erosion: ten days after the procedure, the scab begins to come off.

Bleeding in itself is not dangerous. But you need to undergo examination and treat erosion. Signs of cellular atypia indicate the risk of pathology developing into cancer.

Tumors

Oncological diseases are increasingly common in at a young age, and in premenopausal and menopausal women they are one of the most common reasons bleeding. The tumor can be located on the cervix, in the uterine cavity. Sometimes the discharge takes on an extremely unpleasant odor (of decaying flesh). Only timely diagnosis And radical treatment will help you get rid of the disease in time and increase your chances of survival.

Ectopic pregnancy

Nagging pain in the lower abdomen and bleeding in the middle of the cycle may be a consequence of interrupted ectopic pregnancy. This condition is accompanied internal bleeding, and the blood that poured out is only a small part. The severity of the condition will gradually increase and decrease arterial pressure, tachycardia and signs will appear vascular collapse. This situation requires an immediate response.

When the fertilized egg attaches to the cervix, bleeding also occurs - first at the time of implantation, and then in a new cycle as the embryo grows. This is dangerous for a woman's life.

In premenopausal patients, pink leucorrhoea becomes a consequence of atrophic processes in the mucous membrane. Insufficient lubricant is already released. Therefore, after sex, microcracks occur, causing the discharge to become colored.

Diagnostics

To establish the causes of pathology, the following diagnostic methods are used:

• vaginal smear;
• PAP test;
• colposcopy;
• general blood analysis;
• hormonal profile;
• Ultrasound of the pelvic organs.

Other examination methods are used as indicated, depending on the primary results.

Prevention

Already from the first menstruation, the following are important:

• daily regime;
• proper nutrition;
• adequate rest;
• physical activity;
• protection against STIs;
• strengthening the immune system.

For patients of reproductive age, doctors additionally advise the following:

• regular sex life;
• correct contraception;
• no abortions.

Women who have given birth to more than one child are less susceptible to developing fibroids and endometriosis. And with regular use of oral contraceptives, the risk of developing uterine cancer is significantly reduced.