Bleeding Between Periods: Causes and Prevention

It can be disconcerting to see a bit of blood when you know you’re not due for a visit from Aunt Flo. Mid-cycle bleeding can have a range of causes, but a big one is changing hormone balance. But why would shifting hormone levels cause bleeding in between your menstrual cycles? Let’s clear up the facts on the link between hormone levels and those unexpected red spots.

What is bleeding between periods? Is it normal?

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Any blood that comes out of the vagina not as a result of a normal menstrual cycle is classified as abnormal bleeding. The bleeding you get during your period is caused by the endometrium lining of the womb coming loose and bleeding away, but irregular bleeding can come from other parts of the reproductive system.

For instance, a broken blood vessel in the ovaries could result in some bleeding around ovulation time (also called “ovulation spotting”). Gynecological disorders like fibroids or endometriosis can also cause injuries or abrasions to the uterus. However, in many cases, the root cause comes down to hormone balance.

How do hormones cause spotting between periods?

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The menstrual cycle involves the release of two main hormones: estrogen and progesterone. When estrogen levels are high, the developing egg follicle in the ovaries is encouraged to develop and get ready for ovulation, and the endometrium lining of the womb becomes thick.

After ovulation, progesterone kicks in to support the endometrium. This maintains a suitable environment for a fertilized egg to implant. If the egg isn’t fertilized, the body hits the reset button, releases the endometrium as a menstrual period, and the cycle begins anew.

However, if your levels of estrogen or progesterone aren’t quite where they should be, it can cause problems. An imbalance of the two hormones may leave the endometrium too frail – or, on the other hand, it could thicken too much. Both these can cause a part of the endometrium to come off and result in bleeding between periods.

Mid-cycle bleeding and stress: What’s the hormone link?

Factors like short-term stress or illness can cause a temporary upset in your hormone balance. If you only have one or two instances of spotting, keep an eye on it, but it often clears up on its own before long. However, if you’re dealing with chronic stress (such as from a toxic work environment or relationship troubles), this can mess up your hormone balance in the longer term and cause mid-cycle bleeding.

Gynecological conditions can also lead to hormone imbalance in their own right, so any prolonged or severe mid-cycle bleeding should be checked out by a doctor right away.

Prevent spotting between periods with healthy hormone levels

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Spotting between periods can be frustrating, but there are a number of steps you can take to control your hormone levels.

See your gyno for a check-up

In some cases, spotting between periods has a clear physiological cause like uterine polyps or fibroids. If your mid-cycle bleeding is severe or doesn’t clear up on its own promptly, it’s a good idea to have a doctor take a look at you just to see if there’s anything else going on.

Avoid stress

The hypothalamus is in charge of regulating your reproductive hormones, but when you’re stressed out, it has to put estrogen and progesterone on the back burner. Keep your daily stress levels by setting aside time to relax: remember to enjoy your hobbies, spend time with your friends and stay physically active.

Get enough sleep

It’s no secret that sleep is tied to stress levels: when you’re sleep-deprived, you feel physically and mentally lousy. Not everyone needs the same amount of sleep, but is 6 to 7 hours per night is a good level to aim for. Make a point of getting enough high-quality sleep by avoiding electronic screens (like TV and smartphones) in the hours before bedtime. Studies also suggest that your estrogen levels are influenced by sunlight exposure, so the old Ben Franklin ideal of “early to bed, early to rise” could do you some good!

Diet and nutrition

Hormone levels can come out of whack if you’re not getting a good balance of nutritious food. A diet full of energy-rich but nutrient-poor foods can also lead to excessive weight gain, a known risk factor for hormone troubles. At the same time, calorie restriction and excessive exercise are notorious for throwing off the menstrual cycle – to the point that’s considered a red flag for eating disorders. See your healthcare provider if you need some help getting your eating habits into a healthy balance.

Bleeding between periods can be a sign of infertility

A little bleeding between periods isn’t necessarily a cause for concern. In many cases, it comes down to a slight hormone imbalance. However, in some cases, irregular bleeding can be connected to underlying disorders in the reproductive system. This raises the possibility of problems when you’re trying to conceive. If you have any other uncomfortable symptoms alongside mid-cycle bleeding, or if it seems like it’s going on too long or too intensely, don’t hesitate to talk to your doctor about it for peace of mind.