What Is Breakthrough Bleeding & Why Does It Happen (Updated 2018)


Commonly referred to as spotting, breakthrough bleeding is a regular occurrence that happens between your periods. There are various causes, and most women attest to having spotted once or twice in their lifetime.

If you know the cause, then there is nothing to worry about as it will probably stop. On the other hand, if you cannot explain, it could be a bad sign that something is not right with your body hence the need to contact your doctor. This guide will help you learn the following:

  • What is breakthrough bleeding?
  • When is it probable to happen?
  • Eight factors that can cause breakthrough bleeding
  • Differentiating between breakthrough bleeding and implantation bleeding
  • Tips to help you reduce breakthrough bleeding
  • When should you see the doctor?

What Is Breakthrough Bleeding?

You will notice spotting in the middle of your menstrual cycle, and most women who experience it are the ones using birth control pills with low estrogen. That does not exclude the general use of birth controls.

While using the pill, what you get is ‘light spotting,’ but it is bound to get heavier just like in a regular menstrual cycle. It later goes away if your body takes it time to adjust to the subjected birth control. If you still do not know the cause, such a condition is known as metrorrhagia. A significant breakthrough that is heavier than what you see out of spotting needs immediate evaluation.

When Is It Probable To Happen?

The usual cycle takes 28 days. Some may fall short to 21 while others go to more than 35 days. On day one, the period starts to appear, and this goes on for the next five days.

After that, your hormones work towards ovulation around the 14th day and it may or may not get fertilized. The prior will lead to pregnancy. If not, your body through the help of hormones will adjust to starting the shedding of the uterus lining which gives you another five days of menstruation.

Statistics show that women lose 2-3 tablespoons of blood during the cycle and it is more massive for teens and those approaching menopause. A breakthrough happens outside the usual period. It could be spotting or more bleeding that calls for a tampon.

8 Factors that Can Cause Breakthrough Bleeding

There are many reasons why you might bleed in between the periods. It could be your body adjusting to contraception or some cancerous cells developing – you do not know yet especially if you cannot predict the cause. Most of the breakthrough bleedings will stop and heal on their own, but it is always recommendable to check with the physician.

1) New birth control or the dosage is too low

It is okay to spot in the first three months when using a new control pill according to medical practitioners. The reason behind is because your body is in the process of adjusting to the medicine. The uterus lining is also changing to it.

There is, however, a problem with some of the pills on the market today. Some of them have a very low dosage bringing the cause for spotting after continued use. What happens is that the uterus lining becomes so thin such that the blood vessels supplying blood start to break due to being fragile. There are not enough hormones to facilitate support.

You might find that you do not spot when using a particular brand but it will happen when you switch to generic types. Researchers project the breakthrough cause to be the mismatch between the generic drugs and those from your favorite brand. The difference is enough to be accused.

According to functionality, the non-branded drugs work the same way branded ones do. There is, however, an allowance of natural variables that do not lower how the medicine is supposed to function.

If you start spotting while on a new pill or if it continues after three months, go to your ob-gyn for a checkup and ask about the necessity of switching to another medication.

2) Pregnancy is around the corner

Throughout pregnancy, you will at one point or another, and the first harm should not be a cause for alarm. It happens before you even know something is happening in you. After ovulation, if the egg is fertilized, implantation is the next stage. The process causes some bleeding on the uterus which will go down your vagina. It is never a lot in such circumstances.

3) Already pregnant

Most women encounter what the specialists call hemorrhage or sub-chorionic hematoma. It happens when part of the outer membrane surrounding the embryo (chorion) moves away from the uterine wall (endometrium) causing a space. The separation is then filled with blood, and it is a common thing in pregnant women which should not cause any worry. On the other hand, a more extensive hematoma with other factors at play such as the mother’s age, there a risk of miscarrying.

4) Having sex during pregnancy

As pregnancy progresses, the cervix starts to be sensitive, so it bleeds during intercourse. This one is fine since nothing is happening to the baby. The penis is not long enough to reach the fetus. Otherwise, we would still be very few in this world.

5) STI contraction

Some STD’s like chlamydia and gonorrhea can result in vaginal bleeding if there is no treatment and the infection is progressing to other reproductive organs. They may also bring PID (pelvic inflammatory disease) which causes fatal damage to your fallopian tubes which in turn compromises your fertility.

Many women under the age of 25 who contract either of the two diseases do not see any symptoms during early stages. That is why it is a good idea to go for STD screening once in a while.

6) Miscarriage or ectopic pregnancies

It is common if you are bleeding during pregnancy and no cause to worry. On the other hand, you need to be aware that bleeding is a miscarriage’s first sign. If it unexpectedly starts in early pregnancy, chances are 50-50 that miscarrying is on the way.

Bleeding is also another sign of ectopic pregnancy. If abdominal pains accompany the bleeding, then you need the doctor for a sonogram to rule the ectopic option out. A later call to attention can threaten your life the blood cause was implantation gone wrong.

7) Growths on cervix, ovaries or uterus

Specific non-cancerous forms of growth such as uterine fibroids, ovarian cysts, uterine and cervical polyps develop in women. The ovarian cysts case has a rare instance of bleeding, but some victims may experience a little spotting when ovulating.

Uterine fibroids create fibrous masses that come with heavy and painful menstrual periods but some cases, only breakthrough bleeding happens. Cervical polyps, on the other hand, is experienced by women above the age of 20 and have kids in the past.

It is okay to bleed if you have any of the above growths but the doctor has to perform some tests to clarify on benignancy of the condition.

Women suffering from endometrial (of the uterus) polyp will encounter mid-cycle breakthrough bleeding. It is a polyp that bestows to the uterine tissue aligning the uterus. Most of them cannot lead to cancer but it recommendable to have them withdrawn for safety.

The National Institute of Health reports that 5 percent of the growths can be cancerous or precancerous. Higher risks pose to postmenopausal women taking breast cancer drugs or are having heavy menstrual periods. It can also make it difficult when trying pregnancy.

8) Gynecological cancer

It can be vaginal, ovarian, endometrial or cervical but the first sign gynecological cancer is bleeding. If you are not yet menopause and a recent pap smear ensured that everything is fine, then cancer could not be the cause of spotting.

That is why a doctor needs to scrutinize everything and rule out any abnormal growth of cells. It is a significant problem if bleeding occurs in post-menopause which requires investigation even if it is just a drop. At that point, other causes such the pill are not there so, check with your physician to cancel the cancer option out.

Differentiating between Breakthrough Bleeding and Implantation Bleeding

It is not easy to tell if the bleeding between the cycles is a breakthrough or implantation. For the latter, spotting comes between 10-14 days after you conceive. If conception has already occurred, some women will not see any bleeding.

Both bleeding causes have the same characteristics such as happening between the periods, light enough to not need a pad or tampon. The difference is that a breakthrough bleeding will occur at any time between regular cycles while the implantation case happens after you have missed a period.

For an implantation bleeding, a tip would be to take a home pregnancy test or go for a blood test.

7 Tips To Help You Reduce Breakthrough Bleeding

  • Continue taking your pills:At times, you might think that an abrupt stop in taking medicine will seize the breakthrough bleeding. No, it will make it worse.
  • Quit smoking:Apart from the increasing threat of blood spots, a combination of pills and smoking is dangerous due to the risk of blood clots and stroke.
  • Have a regular schedule when taking the pills:Taking pills irregularly such as sometimes in the night and at times during morning hours will likely cause breakthrough bleeding.  It is recommendable to take your pills at the same time every day. A tip would be to place a reminder on your phone.
  • Check what you get over-the-counter:Birth control pills contain some vitamins and supplements that can reduce the pills’ effectiveness. The main reason is that they can alter how hormones are absorbed by your body. Always check if what you are using can affect birth control.
  • Keep the medicine in pharmacy packaging:The package is designed to keep you on track. Labeling each day makes sure that you do not forget to take your birth control pills. If you take one-two out before the stipulated time, it is possible for you to ignore a dose which may bring in irregular bleeding.
  • Have a balanced diet:If you experience sudden weight loss or gain, it may affect the working of your birth control and lead to bleeding. For you to keep the hormone levels in check, try maintaining your weight and overall health by having a balanced diet.
  • Stress control:Stressing can lead to spotting once in a while. The best part is that controlling your stress level using healthy ways is possible. Try going for a walk or any other activity that can help reduce the pressure.

When Should You See the Doctor for Breakthrough Bleeding?

If the bleeding occurred between your periods or from a birth control pill, it is likely to end without getting treatment.

If you experience heavy and painful bleeding, you need to see a doctor right away. Suspecting STIs should have other leads which include other associated symptoms. Women in menopause should also consult with the physician since bleeding after 12 months of no period is not usual. Menopausal bleeding could be an infection symptom.

Medications that a doctor can subject include:

  • Attempt on burdensome bleeding regulation with drugs such as pills with progesterone and estrogen and inserting an intrauterine device among others.
  • Surgical procedures if bleeding persists which include hysterectomy, or endometrial ablation which involves cauterization of the inner uterus lining which makes it inactive permanently.



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