A woman's menstrual cycle occurs approximately every 28 days, with 21 to 35 days considered normal. Menstruation, or “menstruation,” usually lasts between 3 and 8 days. Bleeding in the middle of the cycle, commonly called “spotting”, is not part of the menstrual cycle, but most cases can be treated easily.
Step
Part 1 of 2: Controlling Spots
Step 1. Take the contraceptive pill
Oral contraceptives or pills are usually used to treat spots. The contraceptive pill regulates the hormonal changes that occur during the menstrual cycle.
The contraceptive pill can help establish regular cycles and prevent overgrowth of the uterine lining in women who don't ovulate regularly. In women who are ovulating, the contraceptive pill can treat abnormal, heavy or excessive bleeding during menstruation
Step 2. Take the contraceptive pill at the same time every day
Missing a pill or inconsistent use of oral contraceptives is one of the main causes of spotting. If this happens, it is recommended to use an additional method of contraception for the duration of the cycle.
Step 3. Take a progestin product
Progestins are synthetic or manufactured forms of progesterone. Progesterone is a natural hormone released by the ovaries that helps regulate the amount of bleeding that occurs in women who don't ovulate regularly. The synthetic form, or progestin, is usually taken by mouth in tablet form.
Progestin products in tablet form contain active ingredients called medroxyprogesterone and norethindrone. An intervention like this requires you to take a progestin once a day for 10 to 12 days a month, for several months. Sometimes, progestin products are prescribed to be taken once a day every day. Other forms of progestin are injections, implants, or intrauterine devices (IUDs)
Step 4. Consider a progestin-releasing IUD
For some women who have episodes of abnormal bleeding, the use of a progestin-containing IUD is a good option. The IUD is inserted into the uterus by a doctor. There's a string so you can check to make sure the IUD isn't moving.
A progestin-releasing IUD can help reduce heavy bleeding by up to 50%, control spotting, and help relieve pain associated with menstruation. In some cases, women who use progestin-releasing IUDs do not menstruate at all
Step 5. Change your method of contraception
If you are already taking birth control pills, talk to your doctor about switching to another type of birth control. You can use pills with different formulas, implants, IUDs, diaphragms, patches, or injections.
If you are using a non-medicated IUD, ask your doctor if you can change the IUD or use another method of contraception. IUD users experience spotting more often than users of other contraceptive methods
Step 6. Limit your use of aspirin, ibuprofen, or naproxen for a month
These agents are useful for relieving pain and discomfort due to menstruation, but they can also thin the blood. This increases the chance of bleeding or spotting between periods.
Step 7. Control stress
Excessive stress can make the body delay or skip cycles completely. Short and long term stress affects a part of the brain called the hypothalamus.
- The hypothalamus is key in regulating the release of many natural chemicals throughout the body, including the ovaries, which regulate normal levels of estrogen and progesterone. When stress occurs, the ovaries cannot properly release hormones, such as the release of progesterone. If progesterone is not released, the buildup of estrogen can cause spotting.
- Both mental and physical stress can affect the menstrual cycle and discharge. Consider moderate exercise, yoga, and relaxation techniques to control stress.
Step 8. Maintain a healthy weight
Obesity increases the risk of uterine cancer. However, heavy physical activity or drastic weight loss also disrupts the menstrual cycle so that menstruation does not come out or is abnormal and triggers spots.
Step 9. Visit the gynecologist every year
Annual examinations include a pelvic exam, Pap smear, and other routine tests to check for abnormalities. Tell your doctor if you have spotting. Occasionally, a pap smear and a pelvic exam may cause spotting, but that's normal.
Part 2 of 2: Knowing When to Seek Medical Help
Step 1. Call your doctor immediately if you are pregnant and bleeding
Spotting or bleeding may be normal, but it may also be a sign of complications in pregnancy, such as miscarriage or an ectopic pregnancy.
Step 2. Seek medical attention if you experience abnormal bleeding accompanied by other symptoms
Additional pain, fatigue, or dizziness requires a doctor's evaluation.
Step 3. Watch for episodes of heavy bleeding
Heavy bleeding between periods, and even during periods, can be an indication of complications that are mostly treatable. The first step in determining the cause of heavy bleeding and finding possible treatment options is to contact a gynecologist.
Step 4. See a gynecologist as soon as possible if you are menopausal and have bleeding
Whether you are on continuous hormone therapy, cyclic hormone therapy, or not taking hormone therapy at all, unexpected bleeding episodes are not normal. Call your doctor if unexpected bleeding occurs.
The risk of cancer increases by about 10% in postmenopausal women who experience vaginal bleeding
Step 5. See a doctor if you don't have your period
If you haven't had your period for 90 days, call your doctor.
Step 6. Call your doctor if you use a tampon and start showing symptoms
Stop using tampons and call your doctor right away if you have a fever, muscle pain, diarrhea or vomiting, dizziness or fainting, and an unexplained rash, sore throat, or notice redness in your eyes.
Step 7. Consider other illnesses
Spots can be caused by conditions or diseases that are related or unrelated to women's health problems. Whatever the cause, your doctor can help determine if it really has something to do with another disease or condition.
- The use of certain medications such as corticosteroids, blood thinners, and even antidepressants has been linked to spotting episodes. Thyroid disease and diabetes are also contributors to spotting between periods.
- Women's health conditions that may cause abnormal bleeding include uterine fibroids, uterine polyps, polycystic ovary syndrome, endometriosis, bladder or vaginal infections, and cancer. Abnormal Pap smears and infections such as gonorrhea and chlamydia can also cause abnormal spotting. Seek medical help as soon as possible if you continue to have abnormal bleeding or spotting.
Tips
- Girls under the age of 8 and women who are not showing signs of puberty should not experience vaginal bleeding. You should call your doctor if bleeding occurs.
- Adolescent girls may experience irregular cycles and may have spotting during the first few years.
- Women who have just started taking the contraceptive pill may experience spotting in the first few months because their bodies are still adjusting to hormonal changes.
- Illness or diarrhea can disrupt the menstrual cycle and cause spotting. Once you heal and return to your normal cycle, the spotting will stop.
- Keep track of what days and how much blood or spotting comes out in the middle of the cycle. This can help doctors determine the best treatment.
- Don't ignore abnormal bleeding. Seek medical attention if you notice any changes in your normal cycle.
