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Do you experience vaginal bleeding or spotting outside of your menstrual period, frequently or occasionally? While the cause is likely to be benign, unusual bleeding deserves your attention.

Bleeding or spotting between periods is something that lots of women experience at some point, either occasionally or regularly, during every menstrual cycle. It is important to acknowledge any non-menstrual bleeding or spotting, as it can indicate medical problems that require treatment. 

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Normal menstrual cycles can last anywhere from 21 to 35 days. Most women have irregular cycles at the beginning and end of their reproductive lives, while some will always remain irregular. Menstrual flow itself also varies from woman to woman and sometimes from month to month — a woman may bleed for as little as three days or as long as a full week. 

It's spotting (very light bleeding) or bleeding outside of the menstrual period, during which the uterus sheds its lining in preparation for a new reproductive cycle that should catch your attention.

"Mid-cycle bleeding" doesn't have to occur right in the middle of your cycle, and unless there is an obvious explanation such as ovulation or implantation bleeding, it should always lead a woman to make an appointment with her obstetrician/gynecologist. 

In this article, we'll take a look at possible causes of bleeding or spotting between periods, as well as the other symptoms associated with these causes. 

Ovulation Bleeding And Implantation Bleeding

Some women regularly experience a light spotting that is easy to miss around the time of ovulation. This is due to hormonal changes. More concretely, because the uterine lining has thickened in preparation for a possible pregnancy but the hormone progesterone has not reached a level at which it can easily be contained. The cervix opens as you approach ovulation, which makes it easier for blood to be expelled. This bleeding is called ovulation bleeding.

Ovulation bleeding is not universal by any means, but a significant minority of women will experience it. It is completely normal and not something you need to worry about. 

Another benign cause of bleeding during your menstrual cycle is an implantation bleeding. If you are trying to conceive and notice a light spotting between seven and 10 days following ovulation, it could be a very early pregnancy sign. An implantation bleeding is created as a tiny embryo implants into the blood-rich environment of the uterine lining. Around 20 percent of women experience this light spotting when they get pregnant.

Uterine Fibroids And Polyps

Uterine fibroids are non-cancerous growths within the uterus, that affect many women of reproductive age at some point. Fibroids develop from the smooth muscular tissue of the uterus, and they can be so small that you'd need a microscope to detect one or so large that they affect the shape of the uterus. 

Fibroids can result in heavy and prolonged menstrual periods, pain (in your back and legs as well as obviously your abdomen), frequent urination and constipation as well as irregular bleeding.

If the pain is severe or you bleed heavily, seek medical assistance immediately. 

Uterine polyps are often confused with fibroids, but they form differently. They are attached to the inner wall of the uterus, and form from the overgrowth of endometrial (uterine lining) tissue. Like fibroids, polyps vary greatly in size. 

Irregular menstrual bleeding, heavy bleeding, and infertility can result in addition to bleeding between periods. Polyps are more common in older women who are approaching the menopause. 

Adenomyosis 

Adenomyosis is a disorder of the endometrium, the tissue that usually lines the uterus. Less well-known then endometriosis — in which endometrial tissue appears outside the uterus — 

adenomyosis is a condition in which endometrial tissue invades the muscular wall of the uterus. 

Adenomyosis is more common in the later stages of the reproductive years, after having children. Besides bleeding between periods, symptoms include heavy and prolonged periods, heavy pain and cramps, passing blood clots and pain during intercourse.

Cervical, Endometrial, And Ovarian Cancer

The possibility that abnormal vaginal bleeding is an indication of cancer is the reason it is always wise to see a doctor if you notice bleeding between periods or after the menopause. 

Cervical cancer typically does not have symptoms in the early stages. When symptoms appear, the cancer is already more advance. Vaginal bleeding, watery discharge that can smell foul and contains blood, and pelvic pain (including during sexual intercourse) would be tell-tale signs.

Vaginal bleeding after the menopause is especially concerning. 

Endometrial cancer causes abnormal vaginal bleeding in its earlier stages, something that facilitates early detection. The  remaining symptoms are the same as described for cervical cancer. 

Ovarian cancerstarts in the ovaries and can then spread to the uterus. Its 

symptoms include abdominal pressure and a feeling of fullness, bloating, digestive problems, frequent urination, low back pain, fatigue and a loss of appetite. 
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