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Unexplained vaginal bleeding in between periods is a symptom women should always take very seriously. Every woman who starts bleeding in the middle of her cycle, when she is not menstruating, should contact her primary care provider, regardless of whether the bleeding is heavy or no more than light spotting. 

Before you see your doctor, however, observe whether the origin of bleeding is truly your vagina and not the rectum or urethra. You can easily do this by inserting a tampon; should it contain blood, you will know that you are indeed dealing with vaginal bleeding. 

Non-Worrying Causes Of Vaginal Bleeding In Between Periods

The reason it is so important to see your healthcare provider if you are bleeding or spotting between menstrual periods is that such bleeding can indicate serious underlying medical problems. Not all bleeding between periods is worrying, however. The following are common causes of bleeding between periods not caused by serious medical conditions. 

Women aged 40 or above may see bleeding outside of their normal menstrual periods because they are entering the perimenopause. The altered hormone levels during the perimenopause can cause you to have irregular, unpredictable periods. As your estrogen levels decrease, vaginal dryness can also lead to post-coital bleeding. Note that some women enter the menopause prematurely, making the perimenopause a candidate-diagnosis in younger women as well. 

Your birth control method may be another cause of bleeding in between periods. Some bleeding in between periods can be expected if you have recently started taking the birth control pill, or on the other hand stopped taking it. Women who have an intrauterine device are also more prone to bleeding in between menstrual periods.

Some women experience a light spotting immediately after ovulation. This is known as ovulation bleeding, and is nothing to be worried about. Such bleeding may be accompanied by slight cramping. 

Women who have recently given birth, those who underwent a pregnancy termination, and those who had a cervical biopsy, an endometrial biopsy, or other pelvic procedures, can also experience some blood loss. 

More Serious Causes Of Extramenstrual Bleeding

A hormonal imbalance, hypothyroid, uterine fibroids, cervical or uterine polyps, an and the use of blood thinners such as aspirin are all possible causes of bleeding between periods. Furthermore, in women of reproductive age, pregnancy complications, miscarriage, and ectopic pregnancy should always be considered as causes. 

Bleeding can also be due to an injury or disease within the reproductive organs. Varicose veins or rough intercourse can be the culprits, but so can sexually transmitted diseases, or pelvic inflammatory disease. 

In some cases, vaginal bleeding between periods is caused by precancer or cancer of the cervix, the uterus, and rarely the fallopian tubes. 

All these conditions deserve to be taken seriously, and that is why women should never ignore the symptom of bleeding outside of their periods. 

What To Expect From Your Doctor's Appointment

While I'd advise any woman who has unexplained bleeding in between periods to see a doctor, you should so do especially urgently if you know you are pregnant, if you have already entered the menopause, if your bleeding is very heavy, or if your bleeding is accompanied by symptoms such as clots, a foul odor, dizziness, and a fever

Your doctor will ask you when the bleeding started and what else you know about it prior to performing tests such as an ultrasound, a pregnancy test, a PAP smear, STD testing, and a cervical and endometrial biopsy as well as blood tests to assess your thyroid and ovarian functioning.

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