Is this normal? When to call the doctor

Is bleeding between periods normal?

In women who are not pregnant, spotting between periods is commonly caused by changes in birth control pills and other hormone therapy, says Dr. Tina Groat. In addition, biopsies and other examinations performed on the cervix and vaginal area can cause bleeding between menstrual periods.

Vaginal bleeding, however, can signal serious gynecologic conditions or other medical problems in pregnant women, post-menopausal women (who have not had a menstrual period in 12 consecutive months) and pre-pubescent girls. Unexpected vaginal bleeding could be a sign of a serious health issue, such as cancer, and should be evaluated by a doctor right away.

Possible causes of vaginal bleeding between periods include:

• Cervical cancer
• Cancer of the uterus or fallopian tubes
• Biopsy or other procedures commonly performed for human papillomavirus (HPV) screenings
• STDs including chlamydia and gonorrhea
• Uterine fibroids and polyps
• Miscarriage and other pregnancy complications
• Interruption/change in use of birth control pills
• Pelvic inflammatory disease
• Vaginal trauma or disease
• Genital warts
• Use of intrauterine device (IUD)
• Ectopic pregnancy
• Vaginal dryness due to lack of estrogen after menopause
• Stress
• Underactive thyroid (hypothyroidism)
• Use of blood thinners

You should see a doctor any time you have unexpected bleeding between periods. Specifically, you should seek immediate medical attention if you experience this under the following circumstances:

• During pregnancy
• After menopause, if you have not had a menstrual period for a full year
• Bleeding is accompanied by other symptoms or pain
• Before puberty
• Bleeding that lasts longer than one week

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