From Tracee Cornforth,
Your Guide to Women's Health.
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Your period was over just last week and now it's back. Maybe this has been happening regularly the last few months. Maybe it's the first time it has happened to you. Whether it's the first time you have experienced irregular bleeding between periods, or just another month of spotting, metrorrhagia (the medical term for irregular bleeding or spotting between periods) is frustrating and can lead to a lot of worry thinking something is seriously wrong.

What is normal menstruation?

Normal menstrual bleeding lasts about five days, and although it may seem like you are losing a lot more blood, the amount of blood lost during your period is only about two to eight tablespoons. Menstruation occurs on average every 28 days; but, anywhere from 25 to 31 days between periods is considered a normal menstrual cycle.

When should you worry about bleeding?

If you are post-menopausal, or younger than 11 and vaginal bleeding occurs you should consult your physician. It's important to be sure that bleeding is coming from your vagina and not from your rectum or urine. The best time for your doctor to determine the cause of menstrual problems is when bleeding is not active.

What causes bleeding between periods?

Although the cause of irregular bleeding can vary according to individual health situations, some of the more common causes include:

• Abortion
• Hormonal fluctuations
• Beginning or stopping oral contraceptives or estrogens
• Low thyroid levels
• Stress
• IUDs occasionally cause slight spotting
• Injury to the vagina from insertion of objects, from malignant cancers, or from vaginal infections
• Certain drugs such as anticoagulants
• Vaginal dryness
• GYN procedures such as CONE biopsy or cervical cauterization

If bleeding is heavy, bed rest may be recommended. Keep a record of the number of pads or tampons that you use so that your physician can determine whether bleeding is abnormally heavy. It's best to avoid taking aspirin because it can prolong bleeding. Whenever you experience irregular bleeding from unknown causes it is wise to call your physician for an appointment, as well as when bleeding occurs after menopause or when other symptoms are present.