What Is Breakthrough Bleeding And What Causes It?

Bleeding between periods (also known as breakthrough bleeding, metrorrhagia, or spotting) can be a concerning and confusing experience for menstruating people. It is defined as vaginal bleeding that occurs outside of the regular menstrual cycle, per Medical News Today. While a typical cycle is 28 days, breakthrough bleeding can be experienced at any point in the menstrual cycle. The severity of breakthrough bleeding can vary from heavy to light spotting, per Healthline. 

Breakthrough bleeding can happen for various reasons — but overall, it is common. Nevertheless, it is vital to pay attention to your body and seek medical advice if you are concerned about any changes in your menstrual cycle. This is especially important if the bleeding is persistent or accompanied by other symptoms such as pain, cramping, or fever, warns Cleveland Clinic. Your doctor can perform a proper diagnosis to help determine the underlying cause and ensure no serious medical issues. 

One of the most common causes of breakthrough bleeding is hormonal birth control. Birth control pills, patches, and injections work by regulating the levels of hormones in the body, which can sometimes cause bleeding, says Medical News Today. This is particularly common in the first few months of starting a new method of birth control, as the body adjusts to the changes in hormone levels.

Other hormonal imbalances can also lead to breakthrough bleeding. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and perimenopause can all cause changes in hormone levels that can affect the menstrual cycle and lead to irregular bleeding, as noted by WebMD. In some cases, breakthrough bleeding can be a sign of pregnancy. Implantation bleeding, which occurs when a fertilized egg implants in the uterus, can sometimes be mistaken for a period or cause spotting between periods, per Healthline.

Certain medical conditions can also cause breakthrough bleeding. Uterine fibroids, endometriosis, and pelvic inflammatory disease (PID) can all cause abnormal vaginal bleeding, says Medical News Today.

If you are experiencing breakthrough bleeding or have any concerns about your menstrual cycle, it's always best to speak to your doctor. While it may be normal for some people to experience occasional spotting between periods, persistent or heavy bleeding may indicate an underlying medical condition that requires evaluation and treatment, warns WebMD. If you experience bleeding between periods, it is important to pay attention to the duration, amount, and timing of the bleeding. If the bleeding occurs after sex or your periods become irregular, you should contact your doctor.

You should also contact your healthcare provider if the bleeding is accompanied by fever, dizziness, weakness, or severe abdominal or pelvic pain not associated with menstruation. These may be signs of another medical condition that your doctor will need to diagnose. Generally speaking, treatment for breakthrough bleeding will depend on the cause. It may include changes in birth control methods, antibiotics if an infection is present, or surgery in some cases.