Breakthrough bleeding is bleeding that occurs outside of the menstrual period and is usually a small bleed that occurs between menstrual cycles and lasts about 2 days.
This type of bleeding outside the menstrual period, also called spotting It is considered normal when it occurs after gynecological exams or changing contraceptives, without requiring treatment and not indicating any health problem.
However, bleeding outside the menstrual period can also be a sign of pregnancy when it appears 2 to 3 days after unprotected intimate contact, for example, or it can be a symptom of pre-menopause when it occurs in women over 40 years of age. Find out what bleeding during pregnancy means.
Main causes
The main causes of breakthrough bleeding are:
1. Stress
Stress is one of the main causes of breakthrough bleeding, as in this situation the woman feels overwhelmed and limited in carrying out her activities, resulting in a lack of hormonal control that can lead to bleeding during the menstrual period.
What to do: in case of stress, it is recommended to perform exercises and aromatherapy to help you relax. In moderate to severe cases, in which stress causes physical discomfort, in addition to breakthrough bleeding, it is recommended to consult a psychologist so that strategies can be developed to combat stressful situations and their effects.
2. Changing contraceptive method
Changing the contraceptive method is also a frequent cause of breakthrough bleeding and usually happens in the first few days after the change, as there is a variation in hormonal levels.
What to do: If the bleeding is due to changing the type of contraceptive, if it is light, it is recommended to wait a week after the change for the body to regulate hormonal levels. In cases where the bleeding is continuous, it is important to go to the gynecologist to assess whether the cause of the bleeding is in fact the change in contraceptive method.
3. Uterine polyps
Uterine polyps are more common in menopausal women, however they can also occur in younger women, which can cause difficulty getting pregnant and changes in menstruation, such as irregular cycle, breakthrough bleeding and after sexual intercourse and pain in the lower part of the abdomen that worsens during menstruation.
What to do: In most cases, uterine polyps do not require treatment, however your doctor may recommend treatment if there is a risk of developing cancer. Learn more about uterine polyps.
4. Polycystic ovary syndrome
Polycystic ovarian syndrome, or PCOS, is characterized by the presence of several cysts on the ovary due to a hormonal imbalance, which can cause changes in the menstrual cycle, including breakthrough bleeding.
What to do: Treatment for PCOS should include lifestyle changes, including physical exercise, a balanced diet and weight loss. In cases where symptoms are more severe, the doctor may recommend the use of oral contraceptives to regulate the menstrual cycle. See more details on the treatment of polycystic ovary syndrome.
5. Thyroid problems
Some changes in the thyroid can cause bleeding outside of the menstrual period, as thyroid hormones directly influence the functioning of the reproductive system, interacting with female hormones, such as estrogen and progesterone, causing changes in the menstrual cycle, such as breakthrough bleeding and difficulty getting pregnant. .
What to do: It is recommended to consult an endocrinologist to have thyroid function evaluated and the change confirmed so that appropriate treatment can be indicated, which may involve the use of synthetic hormones.
6. Infections
Vaginal infections caused by parasites, fungi or bacteria, including sexually transmitted infections, can cause bleeding after sexual intercourse, which can worsen if appropriate treatment is not initiated.
What to do: Depending on the type of infection, the doctor may recommend the use of medication to combat the responsible agent, such as antibiotics or antifungals.
7. After gynecological examinations
Some gynecological procedures can be invasive, such as pap smears, for example, and small bleeding is completely normal and no treatment is necessary.
What to do: If the bleeding lasts more than 2 days or the amount is moderate or severe, it is important to consult a gynecologist for an evaluation, as there may have been an injury caused during the gynecological examination.
When to go to the doctor
It is advisable to go to the gynecologist when breakthrough bleeding is excessive, lasts more than 3 days or occurs in more than 3 cycles, is excessive after sexual intercourse and when vaginal bleeding occurs during menopause.
Make an appointment with your nearest gynecologist to investigate the cause of breakthrough bleeding:
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In these cases, the doctor may perform diagnostic tests, such as a pap smear, ultrasound or colposcopy to evaluate the woman’s reproductive system and identify whether there is a problem causing the bleeding, initiating appropriate treatment, if necessary. Also find out how to treat menstrual bleeding.
How to know if it’s menstruation
To avoid confusion with bleeding outside of your menstrual period, find out when your period should return:
Bleeding after sexual intercourse
Bleeding after sexual intercourse is not normal, only when it is the first intercourse, with the hymen breaking. Some of the causes that can cause bleeding after sexual intercourse are:
- Sexually transmitted infections (STIs);
- Trauma during sexual intercourse;
- Presence of wounds on the cervix;
- Lack of lubrication of the vagina;
- Cervical cancer;
- Ovarian cysts;
- Endometriosis.
In the case of bleeding after sexual intercourse, it is important to consult a gynecologist so that tests can be carried out to help identify the cause of the bleeding. Find out more about the causes after sexual intercourse.
