What causes bleeding in between periods?

Some women experience bleeding about 10-14 days after their period. This is usually caused by a temporary drop in levels of the hormone estrogen at the time of ovulation (when an egg is released by an ovary). This is quite normal.

As well as reduced estrogen levels, you may also experience a hormonal imbalance, which is completely harmless. This could be as a result of stress, or a recent change of diet. Your doctor will be able to diagnose this by taking a blood sample, and advising you about possible treatments.

If you have recently started taking a contraceptive pill as a form of birth control, you may be experiencing what is known as breakthrough bleeding. This is a common temporary side effect of some types of contraceptive pill. Breakthrough bleeding usually clears up on its own after the first month.

However, if bleeding occurs at other points during your menstrual cycle, you should consult your doctor, or nurse practitioner, in order to rule out the possibility of other conditions.

Some of the most common causes of irregular bleeding are outlined below.

• Sexually transmitted diseases (STDs) - if left untreated, STDs can have long-term complications, including infertility. The sooner you are diagnosed, the quicker you can be treated and avoid unnecessary discomfort.
• Thrush - this usually causes itching and discharge but, if it is severe, it may also cause bleeding. Thrush is often falsely believed to be transmitted through sex, but it is actually caused by a yeast infection.
• Cervical erosion - this non-cancerous erosion of cells at the neck of your cervix can lead to bleeding between periods and after sex.
• Pelvic inflammatory disease (PID) - this bacterial infection causes inflammation of the upper female genital tract, including the uterus, fallopian tubes, and ovaries. This can cause vaginal bleeding.

There are also some less common but more serious causes of irregular bleeding which are outlined below.

• Cervical cancer - very rarely, bleeding can be an indication of cancer of the cervix. The earlier that cervical cancer is diagnosed, through having regular smear tests, the higher the likelihood of it being successfully treated.
• Cancer of the uterus - is also a rare cause of bleeding between your periods. Further symptoms may include a pain while you are urinating and abdominal pain.
• Endometriosis - is a condition where patches of womb tissue implant themselves outside of the womb. The fallopian tubes are the most common place where tissue is implanted. It may cause pain and discomfort, and the main complication is an increased chance of infertility.
• Polycystic ovarian syndrome (PCOS) - is a condition that is associated with multiple cysts on your ovaries, with irregular, or absent, periods being an indication. Early diagnosis and treatment can help to reduce your risk of long-term complications developing, such as diabetes.
• Ectopic pregnancy - occurs when an egg is fertilized outside of the womb. Ectopic pregnancies usually occur in the fallopian tubes, although they can also occur in the ovary, cervix, or abdomen.

Vaginal bleeding may be a sign of a possible miscarriage. Seek medical attention immediately if you suspect complications with you pregnancy.

You should see you doctor if you are concerned about irregular bleeding. A doctor will carry out an internal examination to look for any obvious causes of your bleeding.

They may also carry out a speculum procedure. This is where a sterile device is inserted into your vagina in order to view your cervix. A smear test may also be conduct if further laboratory testing is required to establish the exact cause of your bleeding.