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Intermenstrual bleeding
Also known as Bleeding between menstrual periods, Breakthrough vaginal bleeding, and Menometrorrhagia
Vaginal bleeding is any bleeding through the vagina, including bleeding from the vaginal wall itself, as well as (and more commonly) bleeding from another location of the female reproductive system. Generally, it is either a physiologic response during the non-conceptional menstrual cycle or caused by hormonal or organic problems of the reproductive system. Vaginal bleeding may occur at any age, but always needs investigation when encountered in female children or postmenopausal women. Vaginal bleeding during pregnancy may indicate a possible pregnancy complication that needs to be medically addressed.
Source: WikipediaWhat causes it?
The most common causes of intermenstrual bleeding are threatened pregnancy, vulvodynia, and urinary tract infection. Other possible causes, such as pregnancy, are more rare.
What symptoms are related?
Within all the people who go to their doctor with intermenstrual bleeding, 61% report having sharp abdominal pain, 41% report having cramps and spasms, and 41% report having lower abdominal pain.
- Sharp abdominal pain 61
- Cramps and spasms strong predictor 41
- Lower abdominal pain 41
- Pelvic pain 27
- Vaginal discharge 12
- Vaginal pain strong predictor 12
- Heavy menstrual flow 9
- Spotting or bleeding during pregnancy 6
- Frequent menstruation strong predictor 6
- Blood clots during menstrual periods strong predictor 6
- Painful menstruation 6
- Absence of menstruation strong predictor 6
What might my doctor prescribe?
Common Tests and Procedures
Patients with intermenstrual bleeding often receive hematologic tests, urinalysis, complete blood count, pelvis exam, radiographic imaging procedure, standard pregnancy test, glucose measurement and kidney function tests .
Common Medications
The most commonly prescribed drugs for patients with intermenstrual bleeding include medroxyprogesterone, metronidazole topical product, portia, methylergonovine (methergine), modicon, progesterone, rocuronium, ethinyl estradiol / norgestrel, levonorgestrel, ergonovine, tinidazole, ephedrine (kie) and ethinyl estradiol / ethynodiol .
| Medroxyprogesterone | $11 (28 days) | |
| Metronidazole Topical Product | ||
| Portia | $31 (28 days) | |
| Methylergonovine (Methergine) | $74 (14 days) | |
| Modicon | $38 (28 days) | |
| Progesterone | $56 (28 days) | |
| Rocuronium | ||
| Levonorgestrel | Under $1 (0 days) | |
| Ergonovine | ||
| Tinidazole | $102 (7 days) | |
| Ephedrine (Kie) |
Who is at risk?
Groups of people at highest risk for intermenstrual bleeding include race/ethnicity = other, age 30-44 years, race/ethnicity = hispanic, sex == female and age 15-29 years. On the other hand, sex == male, age 1-4 years, and age < 1 years almost never get intermenstrual bleeding.
Age
| < 1 years | 0.0x | |
| 1-4 years | 0.0x | |
| 5-14 years | 0.1x | |
| 15-29 years | 2.6x | |
| 30-44 years | 1.8x | |
| 45-59 years | 0.6x | |
| 60-74 years | 0.2x | |
| 75+ years | 0.1x |
Sex
| Male | 0.0x | |
| Female | 1.7x |
Race/Ethnicity
| Black | 1.3x | |
| Hispanic | 1.8x | |
| White | 0.7x | |
| Other | 1.6x |
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