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I'm bleeding between periods

by Dr Lesley Hickin

question
I've noticed that I am bleeding in between periods. What could be the cause of this? I'm very worried.

answer
It is common to assume that there is a serious cause for bleeding at odd times (doctors call this intermenstrual bleeding or IMB), but for most people there is a simple explanation. The cause depends on various factors. You should visit your GP to have an internal examination at a time when you are not bleeding. Some people who take a hormonal contraceptive pill bleed between periods. This is common during the first 2-3 packs. Missing or taking your pills late can also do this and it is then called breakthrough bleeding.

If you have any pelvic pain or unusual vaginal discharge then IMB can be caused by pelvic infection.

If you think you are at risk from a sexually transmitted infection then you should consult your local genito-urinary medicine clinic to have swabs taken. People with IUCDs are at greater risk.

Abnormalities of the cervix and uterus can also cause unusual bleeding - your doctor may take a cervical smear and arrange a pelvis ultrasound examination.

In older women, when the risk of cancer is greater, a GP may refer you to a gynaecologist for a transvaginal ultrasound, which is more sensitive than conventional scanning. You may also have a hysteroscopy to examine the lining of the uterus.

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