In women of childbearing age, menstruation can be more or less regular. By definition, however, menstrual bleeding occurs once per cycle, with cycles lasting an average of 28 days, with wide variations from woman to woman. Typically, your period lasts 3 to 6 days, but there are variations here too.

When bleeding occurs outside of your period, it is called metrorrhagia. This situation is abnormal: you should therefore consult your doctor.

Most often, these metrorrhagia or “spotting” (very slight loss of blood) are not serious.

There are several possible causes of bleeding outside of a period in women.

Blood loss can be more or less abundant and be associated with other symptoms (pain, vaginal discharge, signs of pregnancy, etc.).

First, the doctor will make sure that the bleeding is not related to an ongoing pregnancy. Thus, implanting an embryo outside the uterus, for example in a fallopian tube, can cause bleeding and pain. This is called an ectopic or ectopic pregnancy, which is potentially fatal. If in doubt, the doctor will therefore order a blood test to look for the presence of beta-HCG, the pregnancy hormone.

Apart from pregnancy, the causes that can lead to untimely bleeding are, for example:

• inserting an IUD (or IUD), which can cause bleeding for a few weeks
• taking hormonal contraceptives can also lead to spotting, especially during the first months
• expulsion of an IUD or inflammation of the endometrium, the lining of the uterus, associated with this expulsion reaction (endometritis)
• forgetting to take birth control pills or taking emergency contraception (morning after pill)
• uterine fibroid (meaning the presence of an abnormal ‘lump’ in the uterus)
• lesions of the cervix or the vulvovaginal region (micro-trauma, polyps, etc.)
• endometriosis (abnormal growth of the lining of the uterus, sometimes spreading to other organs)
• a fall or blow in the genital area
• cancer of the cervix or endometrium, or even of the ovaries

In pre-menopausal girls and women, it is normal for cycles to be irregular, so it is not easy to predict when your period is due.

Finally, infections (sexually transmitted or not) can cause vaginal bleeding:

– acute vulvovaginitis,

– cervicitis (inflammation of the cervix, potentially caused by gonococci, streptococci, colibacilli, etc.)

– salpingitis, or infection of the fallopian tubes (several infectious agents can be responsible including chlamydiae, mycoplasmas, etc.)

Most often, bleeding is not serious. However, it must be ensured that they are not the sign of an infection, a fibroid or any other pathology requiring treatment.

If this bleeding is related to the means of contraception (IUD, pill, etc.), it can pose a problem for the sexual life and interfere with the daily life of women (unpredictable nature of the bleeding). Here again, it is necessary to talk about it in order to find a more suitable solution, if necessary.

The solutions obviously depend on the causes. Once the diagnosis is obtained, the doctor will suggest an appropriate treatment.

In the event of an ectopic pregnancy, urgent care is required: the only way to treat the patient is to terminate the pregnancy, which is non-viable anyway. Sometimes it may be necessary to surgically remove the tube in which the embryo developed.

In case of uterine fibroid causing bleeding, for example, surgical treatment will be considered.

If the blood loss is related to an infection, antibiotic treatment should be prescribed.

In the event of endometriosis, several solutions can be considered, in particular putting on a hormonal contraceptive, which generally makes it possible to control the problem, or a surgical treatment to remove the abnormal tissue.