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Intermenstrual bleeding: causes of bleeding between days

Every woman knows her menstrual period. But did you know that there is also bleeding between the days? Most of the time, intermenstrual bleeding is harmless. We explain when and why they occur.

For many women, menstrual bleeding is not the only bleeding in the month. With them it occurs outside of the cycle to so-called intermenstrual bleeding. So bleeding between normal menstrual bleeds. They are often called additional bleeding. There are a number of reasons for intermenstrual bleeding to occur. We present the most important:
Hormonal disorders are the most common cause of intermenstrual bleeding. If they return at a fixed point in time within the female cycle, they are usually triggered by a lack of estrogen. If the additional bleeding occurs unpredictably, it has other organic causes. They could indicate an illness.
Intermenstrual bleeding usually occurs in the form of Spotting on. They are also called spotting and differ in appearance and consistency from menstrual bleeding. Spotting is more brownish and rather slimy. It only lasts one to three days and is usually easier than menstruation.

What types of intermenstrual bleeding are there?

The ovulatory bleeding
Ovulatory bleeding is an intermenstrual bleeding that occurs as spotting. The cause is a drop in estrogen levels after ovulation. This leads to a hormone withdrawal bleeding. The ovulatory bleeding is rather light and lasts one to three days. She often goes with a light one Middle pain hand in hand. This is so called because it occurs after ovulation, i.e. in the middle of the cycle. This form of intermenstrual bleeding is therefore also called median bleeding. Although it represents a menstrual cycle disorder, it has no medical value from a medical point of view. However, if it occurs very frequently or even regularly, it is advisable to have the symptoms clarified by a doctor. This is the only way to rule out other causes.

A luteal weakness
In the second half of the cycle, the luteal hormone increases progesterone for building up the lining of the uterus and for maintaining a later pregnancy. Women with a so-called luteal weakness have a rather irregular cycle, a shorter second half of the cycle and frequent intermenstrual bleeding in the second half of the cycle. In the affected women, a progesterone deficiency means that no fertilized egg can implant in the undersupplied uterine lining, or that a miscarriage occurs after a short time. With unfulfilled Desire to have children intermenstrual bleeding is an important indicator for the attending physician. Hormone therapy is often an option.

The withdrawal bleeding
The so-called withdrawal bleeding is slightly shorter, weaker and less painful than the normal menstrual period. It occurs during the tablet-free period pill on. There is not enough estrogen and progesterone in the body to make up for those that have built up up to that point Uterine lining continue to maintain. The withdrawal bleeding that follows is therefore called hormone withdrawal bleeding.

As is often assumed, this is not a normal menstrual period. The so-called pseudo-menstruation only comes about through the withdrawal of hormones. The lining of the uterus is also shed, but it cannot be compared to that which is built up during a natural cycle.
When using or stopping other hormone preparations (e.g. during menopause), withdrawal bleeding may also occur.

The breakthrough bleeding
When using hormonal contraceptives - such as the pill - breakthrough bleeding can also occur. However, it occurs outside of the usual tablet-taking break and the withdrawal bleeding that takes place in it. Breakthrough bleeding is a special form of withdrawal bleeding and is usually spotting.
The cause is taking a pill that is not optimally matched to the personal hormone level. The pill often contains too little estrogen or - as with the mini pill - only progestin. The lining of the uterus can no longer be maintained due to the low dose of hormones. Breakthrough bleeding occurs even before the planned pill break.
Similar intermenstrual bleeding occurs when changing the pill. Usually they are harmless. However, if the bleeding is accompanied by abdominal pain and fever, it is important to see a gynecologist immediately.

The implantation bleeding
If a fertilized egg cell successfully nests in the lining of the uterus, it can be injured in the process. The result is light bleeding that occurs about four to six days after the fertilization occurs and can be the first sign of pregnancy. Women with a regular cycle can easily distinguish it from the period, which does not start until 14 days after ovulation. But also the color and strength of the Implantation bleeding (including nidation bleeding) indicate that this is not your normal period. The blood is lighter and more reddish. In addition, the bleeding is not painful and usually very brief. If it lasts for several days, it remains constant, in contrast to the increasing period.

If bleeding occurs during the first few weeks of pregnancy, it is most likely an implantation bleeding. Occasionally, however, it also happens that pregnant women have harmless bleeding at the time when the menstrual period would have been due without pregnancy. The reason for this has not yet been clarified. However, this is not a real menstrual period.

Contact bleeding
The tissues of the vagina and uterus tend to bleed easily. Impetuous Sexual intercourse can sometimes cause what is known as contact bleeding. A gynecological examination can also irritate the tissue so that it bleeds easily. This type of intermenstrual bleeding has nothing to do with the variants listed so far. The blood that emerges is bright red, clear and fluid. If you take appropriate care, the injured areas will heal quickly by themselves. However, if bleeding occurs with every sexual intercourse, if the blood is cloudy or if the bleeding is painful, it is better to see a gynecologist to clarify the symptoms.

Intermenstrual bleeding during pregnancy
During pregnancy you get rid of menstruation for the first time. However, bleeding can still occur. About half of pregnant women report bleeding between periods in the first three to four months of pregnancy. Most of the time, this is not a cause for panic and has nothing to do with an impending miscarriage. However, it is always advisable to see a doctor. Not least to take the worry out of the expectant mother.
Reasons for Bleeding during pregnancy can be an infection of the cervix or vagina. A deep-seated placenta (placenta praevia) can also cause bleeding. Other reasons are usually harmless tissue peeling or contact bleeding after sexual intercourse. A premature detachment of the placenta, which would also be associated with severe pain, is rather rare.
Whether you are pregnant or not, if the intermenstrual bleeding seems strange to you, if you are in pain, if the bleeding is very heavy or if it occurs unusually frequently, see your gynecologist or ask your midwife for advice. Listen to your stomach!

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