What is breakthrough bleeding?

Breakthrough bleeding refers to vaginal bleeding that occurs between expected periods during a woman's menstrual cycle. It is distinguished from menstruation, which is the regular shedding of the uterine lining that happens monthly. Breakthrough bleeding can vary in intensity, duration, and frequency, and can be caused by various factors.

Common causes of breakthrough bleeding include:

1. Changes in Hormone Levels: Fluctuations in hormone levels, particularly estrogen and progesterone, can lead to irregularities in the menstrual cycle. This is common in women who are starting or stopping hormonal contraception or hormone replacement therapy (HRT).

2. Certain Medications: Some medications, such as anticoagulants (blood thinners), certain anti-inflammatory drugs (NSAIDs), and hormonal treatments, can interfere with the menstrual cycle and cause breakthrough bleeding.

3. Stress: Emotional and physical stress can affect the delicate balance of hormones that regulate menstruation, leading to irregular bleeding patterns.

4. Infections and Medical Conditions: Infections of the reproductive tract or underlying medical conditions, such as uterine fibroids, endometriosis, or sexually transmitted infections (STIs), can also cause breakthrough bleeding.

5. Pregnancy: Implantation bleeding, which occurs when the fertilized egg implants itself in the uterine wall, can cause light spotting or bleeding early in pregnancy.

6. Perimenopause: During the years leading up to menopause (perimenopause), hormone levels fluctuate and can lead to menstrual irregularities, including breakthrough bleeding.

It's essential to differentiate breakthrough bleeding from other types of vaginal bleeding, such as postmenopausal bleeding or abnormal bleeding related to underlying medical conditions. If you experience breakthrough bleeding and are concerned about the reasons behind it, it's advisable to consult a healthcare professional for proper evaluation and management. Your healthcare provider can perform examinations or order tests to determine the cause and recommend the appropriate course of treatment, if necessary.