Intermenstrual bleeding

Intermenstrual bleeding, previously known as metrorrhagia, is uterine bleeding at irregular intervals, particularly between the expected menstrual periods.[1][2] It is a cause of vaginal bleeding.

Not to be confused with Menorrhagia.
Intermenstrual bleeding
Other namesMetrorrhagia, irregular vaginal bleeding
SpecialtyGynaecology 

In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation (sometimes referred to by the German term for this phenomenon, mittelschmerz). This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives, such as IUDs or oral contraceptives, in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first 3-4 cycles of oral contraceptive use, a woman should have her prescription adjusted to a pill containing higher estrogen:progesterone ratio by either increasing the estrogen dose or decreasing the relative progestin dose.[3]

Besides the aforementioned physiologic forms, metrorrhagia may also represent abnormal uterine bleeding and be a sign of an underlying disorder, such as hormone imbalance, endometriosis, uterine fibroids, uterine cancer, or vaginal cancer.

If the bleeding is repeated and heavy, it can cause significant iron-deficiency anemia.

Cause

Intermittent spotting between periods can result from any of numerous reproductive system disorders.

Neoplasia:

Inflammation:

Endometrial abnormalities:

Endocrinological causes:

  • Hormone imbalance
  • Dysfunctional uterine bleeding
  • Diets which induce ketosis, such as the Atkins diet
  • polycystic ovarian syndrome

Bleeding disorders:

Drug induced:

  • Use of progestin-only contraceptives, such as Depo Provera
  • Change in oral contraception
  • Overdose of anticoagulant medication or Aspirine abuse

Traumatic causes:

Related to pregnancy:

Other causes:

Terminology

Metrorrhagia is from metro = measure, -rrhagia = abnormal flow.[4] The term is no longer recommended.[2]

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See also

References
  1. MedicineNet.com > Definition of Metrorrhagia Last Editorial Review: 3/17/2003
  2. Bacon, JL (June 2017). "Abnormal Uterine Bleeding: Current Classification and Clinical Management". Obstetrics and gynecology clinics of North America. 44 (2): 179–193. doi:10.1016/j.ogc.2017.02.012. PMID 28499529.
  3. Carlson, Karen J., MD; Eisenstat, Stephanie A., MD; Ziporyn, Terra (2004). The New Harvard Guide to Women's Health. Harvard University Press. p. 385. ISBN 0-674-01343-3.CS1 maint: multiple names: authors list (link)
  4. "Rrhagia | Define Rrhagia at Dictionary.com". Dictionary.reference.com. Retrieved 2013-06-27.
Classification
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