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Breakout bleeding: what it is and when it should be a warning sign

Spotting is characterized by a small amount of blood loss that occurs outside of the menstrual period (for example, during ovulation). It is usually noticed for slightly soiling the panties, but usually does not require the use of a tampon. In most cases it is not a sign of something serious and the bleeding usually stops spontaneously and quickly. But, there are situations that need to be investigated.

Some women may confuse spotting with menstruation, but they are very different conditions. Learn more about breakthrough bleeding, its characteristics and probable causes, paying attention to situations in which it is advisable to seek medical help.

What is breakthrough bleeding

Flávia Tarabini (CRM-RJ 855367), gynecologist at Dr. André Braz (RJ), explains that breakthrough bleeding, also known as spotting, is bleeding that occurs outside the menstrual period in women with regular cycles.

“This is a small-volume, short-duration bleed, with a color ranging from bright red to brown, although it is more commonly a darkened bleed,” adds the gynecologist.

The main difference from menstruation is that spotting has a less vivid color, much lighter flow and lasts less than the menstrual period.

Causes of breakthrough bleeding

Check out the main causes for spotting / non-menstrual bleeding:

  • Continuous contraceptive use: This is a very common cause of spotting. Flávia explains that this is because the endometrium layer is very thin, exposing the blood vessels at the base of the uterus, which can lead to bleeding.
  • Inappropriate administration of the contraceptive pill: there may be bleeding due to low hormones in the bloodstream when the woman fails to take the pills correctly, taking a break, for example, one or two days.
  • Stress: in this situation, there may be hormonal dysregulation, causing bleeding.
  • Changing contraceptive method: this is a normal case, as the body may take a few days to get used to the new method. It can even occur when a woman switches, for example, from one type of pill to another.
  • Infections: there are cases of infection that can bring as a symptom bleeding outside the menstrual period. The same can occur in the case of sexually transmitted diseases.
  • Uterine polyp: a normally benign tumor that settles on the inner wall of the uterus, usually at menopause or post-menopause.
  • Carrying out a gynecological exam: some gynecological exams are invasive, such as the Pap smear itself, and may cause small bleeding after the exam, being something “normal”, which should not extend and/or cause concern.
  • Changes in thyroid function: which can cause dysregulation in hormone production and, among other problems, bleeding outside the menstrual period.
  • Pregnancy: Bleeding can be a sign of pregnancy, more specifically implantation (when the egg fertilized by the sperm lodges in the uterus). But this does not mean that bleeding will occur with all pregnant women, this is not a rule.
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But at what point should it be considered abnormal? “If the bleeding has increased volume, long duration and/or associated pain, it deserves attention”, answers gynecologist Flávia.

Spotting bleeding and pregnancy

A common question is about the possibility of getting pregnant during spotting. It is worth remembering that spotting is not the same thing as menstruation. So yes, you can get pregnant if you don’t use contraception.

However, breakthrough bleeding is often related to the use of birth control pills. In these cases, highlights Flávia, there is no decrease in the effectiveness of the contraceptive method because of this type of bleeding.

Spotting can also happen in early pregnancy. “Nitation occurs 6 to 10 days after fertilization, a stage in which the woman may experience some bleeding, because the embryo is attaching itself to the endometrial tissue (which lines the inner wall of the uterus), causing the rupture of some blood vessels. The duration of bleeding can be from one to three days, with darker colored blood”, explains Flávia.

Seeking medical help

Spotting may last only a few hours or persist for up to two or three days in some cases. It is usually not a sign of something serious, but there are situations in which the gynecologist should be sought.

“Medical help should be sought when there is excessive breakthrough bleeding and/or lasting longer than three days; when breakthrough bleeding recurs for more than three cycles; when bleeding occurs after sexual intercourse or it is accompanied by pain”, highlights Flávia.

Vaginal bleeding during menopause should also be investigated. And if the woman already knows that she is pregnant and notices bleeding lasting more than three days, she should not hesitate to urgently seek medical attention.

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Other than that, in case of doubts, it is always valid to consult with your gynecologist, remembering to do routine exams at least once a year.

Now you know that spotting bleeding, in most cases, is normal and does not pose great risks. But, if they are persistent and / or are accompanied by other symptoms, look for a gynecologist. Enjoy and learn about possible causes for brown menstruation.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.

Tais Romanelli

Journalist graduated in 2009 (58808/SP), freelance writer since 2013, totally adept at working from home. Communicative, always full of topics to talk about and inspiration to write. Responsible at work and outside of it; dedicated to commitments and the people with whom she lives; in love with family, dogs, home, the sea, moments of tranquility and also excitement.

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