From the Research
Intermenstrual bleeding refers to vaginal bleeding that occurs between regular menstrual periods, characterized by unexpected bleeding episodes that happen outside of a woman's normal menstrual cycle, as described in the most recent and relevant study 1. According to the latest evidence, intermenstrual bleeding can range from light spotting to heavier flow and may be accompanied by pelvic pain or cramping in some cases. The bleeding typically occurs midway between periods, often around the time of ovulation, which is why it's sometimes called "ovulatory bleeding." Some key points to consider include:
- Intermenstrual bleeding can have various causes including hormonal fluctuations, structural abnormalities like polyps or fibroids, infections, contraceptive use (particularly hormonal methods), or more serious conditions such as endometrial hyperplasia or cancer, as noted in 1.
- Evaluation typically includes a thorough history, physical examination, and possibly additional testing like ultrasound, endometrial biopsy, or hysteroscopy depending on the patient's age, risk factors, and symptom severity, as discussed in 2 and 3.
- Treatment is directed at the underlying cause and may include hormonal therapy, antibiotics for infections, or surgical intervention for structural abnormalities, as outlined in 4 and 5.
- Persistent intermenstrual bleeding warrants medical evaluation to rule out serious pathology, especially in women over 35 or those with risk factors for gynecologic malignancies, as emphasized in 1.