Intermenstrual Bleeding

By | June 10, 2022

Many women are familiar with intermenstrual bleeding, which occurs independently of menstruation during the female cycle. Intermenstrual bleeding can be both harmless and a symptom of more serious illnesses. Intermenstrual bleeding should therefore always be clarified by a doctor.

What is intermenstrual bleeding?

An intermenstrual bleeding is an additional bleeding that occurs independently of the female menstruation during the cycle. This is a bleeding disorder that can manifest itself in light spotting with light or brownish blood. For hes definition and meaning, please visit

Intermenstrual bleeding can also last for several days and be very heavy. Intermenstrual bleeding should definitely be taken seriously, as it can have very different causes, some of which are not harmless. Therefore, intermenstrual bleeding should always be clarified by the doctor treating you, ideally a gynecologist.

In the event of sudden, very heavy bleeding, which may also be associated with pain, the patient should consult a doctor or the nearest hospital immediately, since such intermenstrual bleeding can be an acute emergency.


There are many causes of intermenstrual bleeding. They can be harmless if, for example, it is ovulation bleeding or contact bleeding after intercourse. Intermenstrual bleeding is often caused by hormones, such as a lack of corpus luteum hormones, menstrual disorders or when taking hormonal contraceptives.

Hormonal disorders of the female cycle are particularly common at the beginning of sexual maturity ( puberty ) or before menopause. Intermenstrual bleeding can also occur in connection with (early) pregnancy, if the fertilized egg implants itself in the lining of the uterus or if there is an ectopic pregnancy. Mental or psychological problems also favor intermenstrual bleeding.

However, diseases of the genital organs such as reproductive or fallopian tube infections, benign fibroids or polyps, endometriosis or benign and malignant tumors can also be triggers. Metabolic diseases such as thyroid dysfunction or diabetes and organ diseases such as liver and kidney disorders must also be clarified by the doctor as the cause of intermenstrual bleeding.

Symptoms, Ailments & Signs

Intermenstrual bleeding can be accompanied by the classic symptoms of menstrual bleeding, such as lower abdominal pain or breast tenderness. The occurrence outside of the normal menstrual cycle is characteristic. Spotting, which can be recognized by its brownish color and is caused by hormones, often occurs shortly before the period. Intermenstrual bleeding is also possible in the middle of the cycle.

This is often lighter and can indicate ovulation. Implantation bleeding from a fertilized egg also falls under the category of intermenstrual bleeding. Inconsistent use of hormonal contraceptives can also trigger intermenstrual bleeding in women. The same applies to a contraceptive dose that is too weak. Intermenstrual bleeding can be a one-off event, but it can also occur regularly in the cycle.

However, not every bleeding between periods is caused by hormones. Bleeding outside of the menstrual cycle can also occur through intercourse. This is also referred to as contact bleeding, which can also occur after the gynecological examination.

It is often a symptom of intermenstrual bleeding that it is significantly weaker than the normal period. It often doesn’t last that long and can be over after two days. Physical exertion or heavy straining when going to the toilet often triggers intermenstrual bleeding, which then often disappears quickly.

Diagnosis & History

In the case of intermenstrual bleeding, the patient should always ask her gynecologist for advice. By questioning the woman, he will first find out the accompanying circumstances such as pain, fever, duration and severity of the bleeding and then choose the examination method based on his suspected diagnosis.

Through a palpation examination and the microscopic examination of the vaginal secretion smear, he receives the first indications of any abdominal inflammation that may be present. A blood test gives the doctor indications of inflammation, hormonal problems or metabolic diseases. With the help of an ultrasound examination, the gynecologist can clarify whether changes such as tumors, fibroids or polyps can be seen in the abdomen.

If necessary, further diagnostics are necessary for clarification: Various surgical interventions such as a hysteroscopy or laparoscopy are available to diagnose intermenstrual bleeding. The course of intermenstrual bleeding depends on the cause and can be harmless or severe, depending on the cause.


Intermenstrual bleeding is usually unproblematic. Complications can occur if the bleeding is particularly heavy or continues for an excessive amount of time. This can lead to anemia and deficiency symptoms, and the risk of a serious underlying disease also increases. Even light bleeding can indicate a serious condition in the female reproductive organs, such as cervical cancer or a fallopian tube infection, which can lead to serious complications if left untreated.

If intermenstrual bleeding is caused by fibroids in the uterus, this can lead to swollen legs, lower back pain, constipation and other consequences that require separate treatment. Sometimes, bleeding outside of the menstrual period also indicates a hormonal imbalance – psychological problems and physical changes can be associated with it.

Infections also occasionally manifest themselves in the form of intermenstrual bleeding and, if left untreated, can develop into serious inflammation in the area of ​​the uterus and cervix. In pregnant women, bleeding between periods can indicate a so-called placental abruption. The placenta detaches from the uterine wall and causes life-threatening complications for both woman and child. In order to exclude these and other complications, intermenstrual bleeding should definitely be clarified by a gynaecologist.

When should you go to the doctor?

A one-time occurrence of light intermenstrual bleeding can indicate the presence of an emotional state of stress. If the challenges in everyday life are mastered and no other abnormalities occur, there is no need to consult a doctor. When young girls start menstruating, there is often no cause for concern either. The harmonization of the menstrual cycle at the beginning and end of the sexually mature period often takes a few months until everything runs smoothly. During this time, natural irregularities occur that have no further clinical significance.

If the symptoms persist for several months or if the bleeding increases in intensity, a doctor is needed. Regular bleeding between periods should be discussed with a doctor, as they can indicate a disease. If there are other symptoms such as abdominal pain, abnormal smell or general malaise, a doctor’s visit is also necessary. If the intermenstrual bleeding occurs after an intense sexual experience, this is also rarely a cause for concern. The techniques should be checked and optimized so that no further interference occurs. If help is needed for this, consultation with a doctor can be sought.

Pregnant women should always consult a doctor immediately if they have bleeding between periods. Bleeding can indicate possible complications during pregnancy and should therefore be clarified as soon as possible.

Treatment & Therapy

The treatment of an intermenstrual bleeding is always adapted to the cause. The gynecologist advises his patient about the possible options. If the cause is ovulation bleeding or contact bleeding, no further treatment is usually required. If there is a hormonal or thyroid problem, the gynecologist will seek drug therapy (hormone replacement therapy or thyroid hormone therapy) to alleviate the symptoms.

In the case of hormonal problems, therapy with the contraceptive pill may also be an option if there is currently no desire to have children. In the case of intermenstrual bleeding during pregnancy, hormonal therapy is also used, as is physical rest and high-dose magnesium administration.

If fibroids, endometriosis, polyps or tumors are the cause of the intermenstrual bleeding, surgery can be considered in addition to hormonal therapy. The primary goal in the surgical removal of the growths is always the preservation of the sexual organs, especially if the woman still wants to have children. If the patient has cancer, the usual cancer therapy such as surgical removal of the tumor, chemotherapy and radiation is available.

If it is a metabolic disease such as diabetes or organic problems such as liver or kidney problems, the gynecologist may refer his patient to a specialist for further treatment of the diseases that are the cause of the bleeding between periods.


A healthy lifestyle is recommended to prevent bleeding between periods. Women should therefore avoid being overweight, not smoking, eating healthily and doing a lot of sport. Regular examinations by the gynecologist help to identify changes in the abdomen at an early stage and to initiate appropriate therapy. Pregnant women who tend to have bleeding between periods should rest physically and avoid stress.


Bleeding between periods is a normal side effect that affects many women. In most cases these are completely harmless. Normally, a medical examination is not necessary. However, if intermenstrual bleeding occurs repeatedly or is very heavy, a visit to a gynecologist is recommended. The doctor can clarify the causes of the intermenstrual bleeding and initiate appropriate countermeasures.

Hormonal changes are often the cause, which can be treated with medication, for example. Follow-up care focuses on finally treating the symptoms and giving the patient further support. Depending on the cause of the intermenstrual bleeding, other specialists can be contacted after the initial treatment.

Possible contacts include internists, gastroenterologists or sex therapists. The gynecologist usually takes on the aftercare of intermenstrual bleeding. As part of the aftercare, a final physical examination usually takes place.

In addition, a patient consultation takes place so that the doctor can clarify open questions. Depending on the cause of the symptoms, the anamnesis can also take place during a consultation. Following the aftercare, the normal gynecologist appointments should be resumed. If the symptoms recur, the gynecologist must be informed.

You can do that yourself

In case of recurring intermenstrual bleeding, the gynecologist should be consulted. If the doctor rules out an organic cause, various home remedies can be used to regulate the cycle. Various medicinal plants and agents with haemostatic effects have proven themselves.

The shepherd’s purse, for example, has a styptic effect and is ideal for heavy or prolonged bleeding. The plant is best taken in the form of a tea until the symptoms have subsided. Monk’s pepper is rich in phytohormones, which support progesterone production in the body. It helps especially with spotting and bleeding between periods that occur repeatedly. The medicinal plant can be taken in the form of capsules from the pharmacy or as a tea.

General measures such as rest and relaxation are also helpful. Affected women are best off taking time off and recovering completely when bleeding occurs between periods. Plenty of water should be drunk and a suitable diet should be observed. Warm pads help against pain and feelings of pressure that can occur with repeated bleeding. You can also do moderate exercise. Light stretching or gymnastic exercises regulate the metabolism and release endorphins. If the symptoms do not subside after these measures, a visit to the gynecologist is recommended.

Intermenstrual Bleeding