Bleeding is a side effect of both medication and surgical abortion , the Mayo Clinic says, so depending on when you got one, it could be causing breakthrough bleeding. In most cases, your provider will let you know how much bleeding to expect, the Mayo Clinic explains. Though bleeding during pregnancy is common and usually harmless, especially in early pregnancy, there are a few worst-case scenarios you should be aware of.
Bleeding is the first sign of a miscarriage , Dr. Cramping may also occur. Bleeding is also the first sign of an ectopic pregnancy, as ACOG explains, which is when a fertilized egg implants somewhere other than inside the uterus, almost always in the fallopian tubes.
While ectopic pregnancies are rare, they can become life-threatening if a tube ruptures. Sometimes bleeding is the only sign of ectopic pregnancy, but other signs can include abdominal, pelvic, and shoulder pain, according to ACOG. If you think you might be experiencing an ectopic pregnancy, call your ob-gyn to talk through your symptoms and figure out any potential next steps. While gonorrhea and chlamydia are usually asymptomatic—one of the reasons regular STI screening is so important—they can both cause vaginal bleeding along with other symptoms.
Endometritis inflammation of the endometrium and cervicitis inflammation of the cervix can occur, as well as pelvic inflammatory disease PID , which happens when bacteria infect the reproductive organs.
This can cause complications like permanent damage to the fallopian tubes that leads to fertility issues. Although gonorrhea and chlamydia are the most common infections associated with PID, according to the Mayo Clinic , other types of bacteria can cause it too.
We put this last on the list to reiterate that there are many, many less worrisome breakthrough bleeding causes that are more likely to be behind your spotting. Excessive blood loss can also lead to anemia, an iron deficiency, and may signal other medical conditions.
Anemia can cause fatigue, pale skin, shortness of breath or dizziness. Bleeding that occurs between periods or is not directly associated with your normal menstruation is referred to as metrorrhagia.
This can consist of light or heavy bleeding or spotting that may be accompanied by abdominal pain or cramps. Metrorrhagia is more common for teenagers and women nearing menopause. Less commonly, bleeding irregularities can indicate pre-cancer or cancer. Stress and lifestyle changes — Stress and lifestyle changes, such as gaining or losing weight, dieting, changing exercise routines, traveling, illness and other disruptions to your normal daily routine can impact your menstrual cycle and cause irregularities.
Birth control — Going on or off birth control pills can affect your menstruation. Some women may experience irregular periods or miss periods for up to six months after stopping birth control pills. Other forms of birth control, such as IUDs, can cause period irregularities lighter or heavier flows or cause your period to stop. Birth control pills that only contain progestin no estrogen may cause bleeding between periods.
Medications — Some anti-inflammatory drugs, anticoagulants blood thinners , hormone medications or steroids can affect menstrual bleeding.
Hormone imbalances — An excess of estrogen and progesterone can cause heavy bleeding. This is most common for girls in the first year or so of having her first period and for women nearing menopause.
Uterine polyps or fibroids — Uterine polyps are small growths in the lining of the uterus, while fibroids are tumors that attach to the wall of the uterus. Women who use hormonal birth control often experience breakthrough bleeding, particularly if they have recently switched contraceptive methods.
Breakthrough bleeding may occur for several months, as the body adjusts to the new form of birth control. Monthly packs usually contain 3 weeks of hormonal pills and an additional week of placebo pills. During this final week, a period will occur because the person is not receiving contraceptive hormones.
Other hormonal contraceptive pills, some containing ethinylestradiol and levonorgestrel, extend the amount of time between periods. For example, a person taking this medication may get a period every 3 months.
This method of contraception is also likely to cause breakthrough bleeding. There are also various birth control methods that may cause people to stop menstruating completely while the drug is active or device is inserted.
These include the implant, depo-provera, and mirena. The current medical consensus is that long term or even continuous use of birth control pills is safe, as menstruation is not physiologically necessary. Women taking hormonal contraceptives may be more likely to experience breakthrough bleeding if they:. IUDs are popular forms of birth control. No daily pill is required, and a device can be functional for several years.
Hormonal IUDs release a contraceptive medication called progestin, while copper IUDs prevent pregnancy without the use of hormones. Both types cause changes to the menstrual cycle, and any such disruption may lead to breakthrough bleeding. Endometriosis occurs when tissue similar to the lining of the uterus grows elsewhere in the pelvic area. This tissue may develop in the ovaries or fallopian tubes, or around the bladder or bowels.
Uterine fibroids are abnormal growths that form in or around the uterus. There are many causes, including genetics and hormones. Some people with uterine fibroids have no symptoms. Others experience breakthrough bleeding. Additional symptoms include:. As many as 30 percent of people who have been pregnant experienced breakthrough bleeding in the early stages. The cervix is located at the base of the uterus. Mol Cell Endocrinol. Cho MK. Use of combined oral contraceptives in perimenopausal women.
Chonnam Med J. Cleveland Clinic. Birth control: the pill. Reviewed November 4, Norethindrone is superior to combined oral contraceptive pills in short-term delay of menses and onset of breakthrough bleeding: a randomized trial.
BMC Womens Health. French V. What you should know about breakthrough bleeding with birth control. American College of Obstetricians and Gynecologists. Published January Centers for Disease Control and Prevention.
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I Accept Show Purposes. Persistent or heavy vaginal bleeding should always be investigated by a healthcare provider. How effective is the birth control pill? Was this page helpful? Thanks for your feedback! Sign Up.
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