At childbearing age, non-pregnant women have their monthly bleeding approximately every three to five weeks. Occasionally, however, extra bleeding occurs outside the cycle, which can have many harmless but also dangerous causes. Therefore, a bleeding should be taken seriously and clarified by the gynecologist.
Hemorrhage and spotting
The blood outlets may be slight spotting or prolonged extra bleeding. Spotting is a condition known as bleeding with a small amount of brown blood that occurs just before menstruation, at the middle of the cycle, or at the time of ovulation.
If short-term bleeding occurs, the doctor will - depending on the age - first clarify any possible pregnancy before looking for organic causes in the area of the vagina, uterus and ovaries as well as for hormonal disorders, metabolic disorders or psychosomatic factors.
In a light, bright red bleeding after intercourse is often an injured vessel, eg in the vagina, the cause of this bleeding. The intake of estrogens can then bring about an improvement.
Inter-bleeding: signs of cancer?
But it can also be a cancer of the cervix behind such a bleeding stuck. In the early stage of this cancer, the affected tissue is cut out in a conical shape; in an advanced stage, the uterus is completely removed and radiotherapy and / or chemotherapy are performed.
Also, if cells of the endometrium (uterine cancer) have changed malignantly, bleeding can occur. The therapy consists either of a scraping of the uterus, hormone treatment and radiotherapy or the uterus (possibly also lymph nodes) is removed and a radiotherapy performed.
Inflammatory bleeding and plump follicles
There are a number of other inter-haemorrhages that are due to serious organic causes. Inflammatory bleeding can occur when the lining of the uterus is chronically inflamed (endometritis). Acute inflammation of the fallopian tubes and ovaries can even be life-threatening. Therefore, sufferers should immediately go to the doctor, when in addition to bleeding still severe pain in the abdomen, fever and a general feeling of malaise occur.
If the cause is a bacterial infection, you probably need to be treated with antibiotics. Long-lasting bleeding is usually the result of benign muscle tumors (fibroids) in the uterine wall or on the outside. Ovarian cysts make permanent lubrication bleeding. They are due to a hormone disorder. The mature follicle does not burst for one or more cycles and forms a cyst. Treatment may be by hormonal contraceptive and progestogens.
Hormonal imbalances are often the cause of spotting
For the most part, the following types of spotting or bleeding have mostly benign causes:
- Ovulation bleeding: This slight and brief one to three-day bleeding occurs at the time of ovulation. Cause is the drop in the hormone estrogen shortly after ovulation. In order to stabilize the hormone situation in the case of ovulatory bleeding, taking the pill or treating it with estrogen or progestogen estrogen preparations at the middle of the cycle may be advisable.
- Spotting before or after the period due to luteal weakness (premenstrual hemorrhage) or delayed luteal decay (postmenstrual hemorrhage): The yellow body develops after ovulation and produces small amounts of estrogen and especially progesterone (the corpus luteum hormone). If necessary, a hormone disorder can be compensated by hormone replacement therapy with progestogen preparations. However, growths or tumors in the uterus or inflammation in the pelvic area may also be the cause.
- Bleeding at the start of a low-estrogen pill: Intake of the mini-pill (low-dose progestogen), the three-month syringe and the insertion of a spiral can lead to an intermediate bleeding.
- Nidation bleeding: It occurs when an embryo is implanted in the uterine lining, ie about 7 to 10 days after ovulation. Often, bleeding from the hemorrhage is not visible to the outside.