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Forum Name: Gynecology

Question: Bleeding between periods with pelvic pain


 rainbow23 - Mon Nov 07, 2005 4:02 pm

Hi,

The past 2 months I have been bleeding between periods.. its never a lot, but it might happen for a week straight and then my discharge will go to white and then back to red/brown another week later. With this I've also been having some pelvic pain and sometimes tylenol won't help at all. My periods are still regular and also, I am a virgin and have never used tampons. Please help! I've never had problems like this before and I'm concerned.

THanks.
 Dr. Tamer Fouad - Sat Jan 07, 2006 6:25 am

User avatar Hello,
"Spotting" refers to unexpected bleeding that does not require the protection of a sanitary or a tampon.[1] Normally it doesn’t reach the underwear, but rather is swiped with toilet paper after a bowel movement or urination. The blood can be pink-tinged mucus, rusty brown or bright red. Brown discharge usually indicates "old blood".

Normal spotting is what may occur at the very end of your bleeding days. A day or two of spotting after 3 to 5 days of “bleeding” is normal, and just the end of the bleeding period. This is also known as post-menstrual spotting. In this case you are just "cleaning out" your uterus/vagina. This may be caused from the uterus not completely shedding the products of menstruation, minor vaginal/cervical trauma during intercourse, hormonal imbalances.

Spotting that occurs in the middle of your cycle or spotting that occurs some ten to fourteen days prior to the start of the next cycle is normal too. This spotting may occur during ovulation. Seeing a spot of blood during ovulation is considered an excellent fertility sign. It is thought that mid-cycle spotting occurs for one of two reasons. First reason is possibly that when the egg bursts through the follicle, a little bleeding may occur. This blood will then make its way out and show up as “spotting”. Or, during ovulation, the level of estrogens changes, and this sometimes prompts the uterus to shed a bit of lining, which shows up in the form of “spotting.”

Abnormal spotting shows up at times other than the above mentioned times. Abnormal spotting lasts for days. It’s abnormal to spot days before your menstrual cycle is due.

The causes of abnormal spotting vary.

One common cause of spotting is low progesterone. It’s the hormone progesterone that helps to maintain the uterine lining for pregnancy and when progesterone level drops, the menstrual cycle occurs. In women who are deficient in progesterone, they will see spotting several days to a week before their cycle is due. This can also cause minor infertility and early miscarriage.

Another reason spotting may occur could be uterine fibroids, which are fairly harmless, but need to be kept an eye on. Endometriosis, birth control pills are a few other reasons spotting may occur. The most harmful reasons for spotting are possible sexually transmitted diseases and some cancers.

It is advisable if you have recurring spotting each month to have your healthcare provider to exam you, just to rule out possible harmful reasons for it and to help you to deal with and/or cure the reasons behind the spotting.

If this has continued regularly then you should see your doctor. After excluding the causes above, s/he may consider dysfunctional bleeding which is common in young women below the age of 20.

Best regards.

References:
==========
1. Thorneycroft IH. Cycle control with oral contraceptives: a review of the literature. Am J Obstet Gynecol 1999;180(2 pt 2):280-7.

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