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Bleeding during a regular menstrual period should last between 2 and 5 days. Bleeding that lasts for longer or shorter than this duration (resulting in a very short or long menstrual cycle) constitutes abnormal bleeding.
Excessively light or very heavy periods (menorrhagia), absence of a period (amenorrhoea), or bleeding between periods (metrorrhagia) also fall under the category of abnormal bleeding.
There are several conditions that can cause abnormal bleeding as a symptom, such as endometriosis, irregular hormone levels (including oestrogen, progesterone, insulin, or thyroid hormones), various contraceptive methods, PCOS, cysts, fibroids, pregnancy, miscarriage, or functional uterine problems.
If you are experiencing any of the following symptoms, it is advisable to make an appointment with one of our doctors: an unusually short or long menstrual cycle (bleeding every three weeks or less, or less than every five weeks), excessively heavy periods, or severe pain during your period (such as having to change your sanitary products every hour or being unable to manage your flow with pads).
Bleeding between periods can be caused by several factors. Hormonal imbalances, such as fluctuations in oestrogen and progesterone, can disrupt your cycle. Birth control methods, including pills, patches, or IUDs, may also cause spotting, especially when first used.
Uterine fibroids or polyps, endometriosis, and pelvic inflammatory disease (PID) can lead to abnormal bleeding. Early pregnancy or complications such as a miscarriage or ectopic pregnancy might cause spotting as well. Thyroid disorders and, although less common, certain cancers like cervical or endometrial cancer can also result in irregular bleeding.
Lifestyle factors can significantly impact menstrual bleeding patterns. Here’s how stress, exercise, and diet play a role.
Stress: Can disrupt hormonal balance and lead to irregular bleeding.
Excessive Exercise: May affect hormonal balance and menstrual patterns.
Significant Weight Changes: Can cause hormonal imbalances that impact bleeding.
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Keep a detailed record of your bleeding, including the timing, duration, frequency, and any other symptoms you experience (e.g., pain, fatigue). Note any recent changes in your menstrual cycle or unusual spotting. Be prepared to discuss your medical history, including any medications you’re taking (prescription, over-the-counter, or herbal supplements), past gynecological issues, and any chronic conditions. Be ready to talk about factors such as stress, exercise, and diet, as these can sometimes impact bleeding patterns. Write down any questions or concerns you have about your symptoms, potential diagnoses, or treatments.
The healthcare provider will start by reviewing your medical history and discussing your symptoms in detail. An examination may include a pelvic exam, and possibly an abdominal or breast exam, depending on your symptoms. Diagnostic tests might be recommended to determine the cause of the bleeding, such as blood tests for anaemia, hormonal imbalances, or clotting disorders. Additional procedures may include ultrasounds to visualise the uterus and ovaries, Pap smears for cervical abnormalities, an endometrial biopsy to assess the uterine lining, and a hysteroscopy to examine the inside of the uterus with a thin, lighted tube.
If a diagnosis is made, the provider will explain the condition and discuss treatment options. Common causes of abnormal bleeding include hormonal imbalances, fibroids, polyps, or other conditions affecting the reproductive system. Depending on the diagnosis, treatment may include medication (e.g., hormonal treatments or contraceptive pills), lifestyle changes, or, in some cases, surgical interventions. You may need follow-up appointments to monitor your condition and response to treatment. The provider will inform you about what to expect and when to return.
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