At childbearing age, non-pregnant women have their monthly bleeding approximately every three to five weeks. Occasionally, however, extra bleeding occurs outside the cycle, which can have many harmless but also dangerous causes. Therefore, a bleeding should be taken seriously and clarified by the gynecologist.
Hemorrhage and spotting
The blood outlets may be slight spotting or prolonged extra bleeding. Spotting is a condition known as bleeding with little brown blood that occurs just before menstruation, mid-cycle, or ovulation.
If temporary bleeding occurs, the doctor, depending on age, will first check for any possible pregnancy before looking for organic causes in the vagina, uterus and ovaries, as well as hormonal, metabolic or psychosomatic factors.
With a light, bright red bleeding after intercourse, an injured vessel, e.g. in the vagina, the cause of this bleeding. The intake of estrogens can then bring about an improvement.
Interstitial bleeding: signs of cancer?
But it can also be a cancer of the cervix behind such a bleeding stuck. In the early stage of this cancer, the affected tissue is cut out in a conical shape; in the advanced stage, the uterus is completely removed and radiotherapy and / or chemotherapy are carried out.
Also, if cells of the endometrium (uterine cancer) have changed malignantly, bleeding may occur. The therapy consists either of a scraping of the uterus, hormone treatment and radiotherapy or the uterus (possibly also lymph nodes) is removed and a radiotherapy performed.
Inflammatory bleeding and plump follicles
There are a number of other inter-haemorrhages that are due to serious organic causes. Inflammatory bleeding can occur when the Uterine lining chronically inflamed (Endometritis). Acute inflammation of the fallopian tubes and ovaries can even be life-threatening. Therefore, sufferers should immediately go to the doctor, when in addition to bleeding still severe pain in the abdomen, fever and a general feeling of malaise occur.
If the cause is a bacterial infection, it probably needs to be treated with antibiotics. Long-lasting bleeding is usually the result of benign muscle tumors (fibroids) in the uterine wall or on the outside. Ovarian cysts make permanent lubrication bleeding. They are due to a hormone disorder. The mature follicle does not burst for one or more cycles and forms a cyst. Treatment may be by hormonal contraceptive and progestogens.
Hormonal imbalances are often the cause of spotting
For the most part, the following types of spotting or bleeding have mostly benign causes:
- The Ovulationsblutung: This slight and brief one to three-day bleeding occurs at the time of ovulation. Cause is the drop in the hormone estrogen shortly after ovulation. In order to stabilize the hormone situation in an ovulatory bleeding, taking the pill or treatment with estrogen or progestogen estrogen preparations in the middle of the cycle may be advisable.
- spotting before or after the period due to yellow body weakness (premenstrual hemorrhage) or delayed luteal body regression (postmenstrual hemorrhage): The yellow body develops after ovulation and produces small amounts of estrogen and especially progesterone (the corpus luteum hormone). If necessary, a hormone disorder can be compensated by hormone replacement therapy with progestogen preparations. However, it can also cause growths or tumors in the uterus or inflammation in the pelvic area.
- Bleeding at the start of a low-estrogen pill: Intake of the mini-pill (low-dose progestin), the three-month syringe and the insertion of a spiral can lead to an intermediate bleeding.
- A Einnistungsblutung (Nidation bleeding): It occurs when an embryo is implanted in the uterine lining, i. about 7 to 10 days after ovulation. Often, no bleeding from the outside is not visible at all.