Bleeding between periods

Overview

Bleeding between periods is known as inter-menstrual bleeding. It is quite common, and if you experience just a single episode you need not be overly concerned.

Possible causes

Common causes are medications containing oral hormones (estrogen, progestogen) such as in contraceptive agents and other oral hormonal therapies.

Ectropion, endometriosis, and polycystic ovarian syndrome (PCOS) can also be associated with inter-menstrual bleeding.

Persistent inter-menstrual bleeding may be caused by genital tract infections, polyps within the uterus or cervix, and rarely cancer of the cervix.

What to do

If you have persistent intermenstrual bleeding, you should see your GP. First-step investigations may include an examination, pap smear, or vaginal ultrasound scan.

How we can help

If you are experiencing bleeding between periods and would like to talk to us about how we can help, please feel free to contact us. You can also request an appointment online.

Further information

Conditions

Cervical cancer

Cervical cancer is cancer that forms in a woman's cervix, at the lower part of the uterus. It is caused by the human papillomavirus (HPV), a common virus which also causes genital warts. There are many different types of HPV virus, and only a few are linked to the development of cervical cancer. Find out more

Ectropion

An ectropion is when the inside of the cervix (endocervix) becomes everted on to the outside of the cervix. The endocervix is more fragile, and can bleed with contact. Find out more

Endometriosis

Endometriosis is a common disorder that affects many women in New Zealand. It occurs when endometrial tissue, which should only be found in the uterus, also grows outside the uterus, such as on ovaries or the bowel. This can be very painful and is why women with endometriosis usually have pain around the same time as their period. Find out more

Infection

An infection is the invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body. An infection is a cause that is always considered in women with abnormal bleeding. Find out more

Polycystic ovarian syndrome (PCOS)

PCOS is a very common disorder in women. Symptoms vary, and can include irregular or absent periods, excess hair, weight gain or difficulty falling pregnant. Find out more

Polyps

Polyps are common benign growths in the uterus, cervix or vagina. Endometrial and cervical polyps can cause bleeding between periods. Find out more

Procedures

Colposcopy

A colposcopy is performed when a woman has had abnormal pap smears. A speculum is placed in the vagina, and the cervix visualised using a colposcope. This provides a magnified view of the cervix so that a targeted biopsy can be taken. Find out more

Ectropion treatment

Ectropion is common, and treatment is generally not required. When bleeding is persistent and troubling, women may consider ablative treatment such as cautery (electrosurgery). Colposcopy may also be used to diagnose and treat this area.

Endometriosis resection

This entails keyhole surgery, where a camera is placed through the bellybutton to view the pelvis. The abdomen and pelvis are carefully explored, and abnormal tissue removed. Cysts may also be removed from the ovaries.
Find out more

Hysterectomy

A hysterectomy is when a woman's uterus is removed. This may be because methods to stop heavy bleeding are not successful, side effects of medications are intolerable, fibroids are problematic or endometriosis is severe enough that a more permanent solution is required. Find out more

Mirena

A mirena is a small plastic device placed inside the uterus with small strings extending out through the cervix. In addition to being used for contraception, mirena can be used to treat endometriosis. Find out more.

Treatment for infections

If an infection is the cause, treatment with antibiotics is required. This is generally given orally, but if an infection is severe, antibiotics given intravenously may be required.

Treatment for PCOS

Treatment of PCOS depends on what symptoms are causing problems. Women with PCOS may need treatment for issues such as sub fertility, diabetes and heart disease.

Hysteroscopy

A hysteroscopy is a common gynaecological procedure, placing a thin camera through the cervix to evaluate the inside of the uterus (the endometrial cavity). This may be as an investigation or a treatment. Find out more

Endometrial ablation

A treatment for heavy menstrual bleeding that involves a general anaesthetic and a controlled cauterisation of the endometrium (the area that is shed during menstruation). It may be a suitable alternative to hysterectomy, but has higher rates of recurrence. Find out more