How to explain discharge and bleeding outside of periods?

In doctor and gynecologist language, we talk about losses and bleeding outside the rules - in cool language, it's spotting - and in Larousse language, we talk about metrorrhagia... In short, let's talk about the left behind of this world: the many women whose periods show up before they really start, just to test the waters, then hesitate to leave after the party...

The different reasons for bleeding outside of periods

There are plenty of reasons that explain the appearance of bleeding between periods and it is rarely the cause that we imagine (“I have ovarian cancer and I will die in 2 months, I absolutely have to go see Machu Picchu before dying”). Let's list the crime scenes and suspects, before searching and finding the real culprits.

The crime scenes

• light bleeding outside of menstruation when using (use, forgetting or stopping) hormonal contraception (progestins of the pill or implant type);
• bleeding when wearing a copper IUD (IUD);
• blood loss during pregnancy or after childbirth;
• bleeding when one is about to be freed from bleeding (pre-menopause);
• blood loss with no apparent signs of tampering.

The suspects, classified into 3 categories

Bleeding due to hormonal imbalances

• stress and emotions (the body secretes hormones to overcome stress with the effects of reducing progesterone production and increasing estrogen production);
• pre-menopause (decrease in estrogen and progesterone hormone levels then cessation);
• jet-lag (here, several hormones such as melatonin and cortisol are complicit in the disruption of the hormonal cycle);
• change in contraception.

Bleeding due to pregnancy

• this problem is normal during the first months of pregnancy (we say hello to anniversary periods! Light bleeding occurring on the date when the period should have appeared);

• ectopic pregnancy (pregnancy that grows outside the uterine cavity and causes irregular bleeding with pain and discomfort).

Bleeding due to gynecological pathology or infection

• uterine fibroids (benign tumors located on the wall of the uterus);
• uterine polyp (growth developing in the endometrium);
• a vaginal infection (mycosis or infection transmitted during sexual intercourse);
• vaginal inflammation (vaginitis from vaginal infection or irritation without vaginal infection);
• endometriosis (migration of endometrial cells outside the uterus subjected to hormones);
• endometritis (infection of the endometrium);
• acute cystitis (urinary tract infection affecting many women and causing bleeding);
• a benign ovarian cyst (disappearing spontaneously after menstruation or after prescription of appropriate medication);
• cancer of the uterus or ovary (the most suspected, but the least often culprit after examinations and biopsy).

Bleeding from another cause

• small wound on the cervix (after sexual intercourse, vaginal examination or pap smear);
• ovulation (light bleeding and moderate pain during the rupture of the follicle and the expulsion of the oocyte).

Bleeding outside the rules: when to worry?

Bleeding outside of periods is the story of my life. Between spotting, my heavy periods and my “double period” bonus months, I am living proof that you can survive without any problem with 30% less blood volume! But after evenings of Google hunting down the right information and trying to identify the cause of my bleeding outside of the rules, I soon discovered that I was not unique. Indeed, many women are affected. Another thing that doesn't make me special.

Word of a gynecologist (and I consulted a good dozen of them), hundreds of boring articles that I read and the concrete fact that I am writing this article after all my hemorrhages. If metrorrhagia does not persist for more than 10 days, this is not a problem: it is a normal abnormality. I know, in our "instagram-world", it's hard to accept that not everything is settled and spotless.

Above all, we would like to be able to find a culprit so that our misery has a meaning, but sometimes there is none. In this case, instead of blaming the world and our mother, we get reusable sanitary napkins, washable panty liners or period panties certified OEKO-TEX® STANDARD 100. Thus, we limit the “murdered panties” budget and we stop massacring the Earth at the same time. And above all, we no longer wait to have cancer to give ourselves permission to go around Cuba by bike. I assure you, dying, we will all do it one day.

What if bleeding outside of periods continues?

In order to rule out any risk of fibroids, polyps, ectopic pregnancy, infection or cancer, you should consult your doctor or gynecologist in the event of bleeding between periods. Only these health professionals can prescribe the examinations (dosage, biopsy, endovaginal ultrasound, etc.) necessary for diagnosis and the prescription of appropriate medication.

So, you will say to me, this article is “sympathetic”, but for those whose bleeding outside the rules persists and for whom there really is a culprit, it does not help much. Patience, I'm preparing a full article for you on each suspect and how to know if it's really your culprit!

By Valerie.