Intermenstrual bleedings or spottings before or after your period are smaller bleedings that occur between periods. It is completely normal and can be a blood-mixed discharge that is both brown and red. Although harmless, it can be annoying when bleeding comes without warning and leaves stains. There are several reasons why you may experience intermenstrual bleedings. Here is a look at some common causes of intermenstrual bleeding. 

What is intermenstrual bleeding and spotting?  

Intermenstrual bleeding and spotting are minor bleeding episodes that occur irregularly when you are not expecting your period. Intermenstrual bleedings can look different from time to time; they can be red, brown, pink or like a blood-mixed discharge. Spotting is when there are only a few drops of blood. It is also common to have intermenstrual bleedings as a part of your period, it can happen just before or after your regular period and is not dangerous. Intermenstrual bleedings can also occur when you are ovulating. 

Reasons for intermenstrual bleeding  

Examples on causes of interstitial bleeding:  

• You have started using contraception with hormones or changed contraceptives  
• You forgot to take your birth control pill or to replace your contraceptive ring or patch  
• You recently took an emergency contraceptive pill (morning after pill) 
• You recently started to menstruate, and your period has not become regular yet  
• You are going through menopause  
• You are ovulating  
• You are pregnant 

Intermenstrual bleedings and spotting are very common during the menstrual cycle. It can happen before your period, after your period or when you are ovulating. If you have just started using hormonal contraceptives, it is common to experience intermenstrual bleeding. This is because there is a change in your body, and it needs to get used to the hormones. These contraceptives can for example be the birth control pill, the mini pill, the IUD, the contraceptive implant or the hormonal contraceptive injection. Intermenstrual bleedings usually disappear after a period of using the contraceptive. 

How to stop intermenstrual bleeding:

If you continue to have intermenstrual bleedings, even after taking your contraceptive for a long time, and find it uncomfortable, you can contact a midwife to change your contraceptive method. If you have missed taking a contraceptive pill, replaced your contraceptive ring or contraceptive patch, or taken a morning after pill, you may experience some minor bleeding. If you have had unprotected sex and start to experience intermenstrual bleeding and spotting after a while, it may be an early sign of pregnancy. This may be due to the egg attaching to the uterus, also known as implantation bleeding or nidus bleeding. 

Intermenstrual bleedings can also be linked to stress, both physical and psychological. Stress can create a hormonal imbalance that can lead to intermenstrual bleedings and irregular periods. 

When should I seek care for intermenstrual bleedings?   

• You have had unprotected sex and started to bleed. This may be because you have caught a sexually transmitting disease such as chlamydia or gonorrhoea.  
• You have been using the same contraceptive method for a long time and you are still experiencing intermenstrual bleeding.  
• You experience intermenstrual bleedings that cannot be linked to your period, hormonal contraceptives or ovulation. 

If you have experienced intermenstrual bleedings that is not related to your contraception or ovulation, it may be due to an infection, a sexually transmitted disease or cell changes. It may sound scary, and it is nothing to start worrying about, but it can be good to check so that these reasons can be excluded. If you suspect any of these conditions, contact a health centre for help. Remember, no one knows your body like you do.