Bloody discharge all the time. Why does I bleed outside of my period?

Bloody vaginal discharge is not a specific disease, but the name of a number of symptoms that have a diverse nature and various causes. Bloody discharge can occur at any period of the menstrual cycle with varying intensity and duration. Bloody discharge has strictly defined characteristics corresponding to one of the phases of the menstrual cycle, which allows the gynecologist to diagnose the cause of its formation.

Norms of vaginal discharge

Natural vaginal discharge can be classified into several groups, which depend on many factors:

• age;
• hormonal intensity;
• sexual activity.

It is important to be aware that girls during puberty are out of the question of any discharge, much less bloody. This is determined by the characteristics of the hormonal microclimate and the structure of the internal genital organs.

If a 10–12 year old girl begins to have discharge that has a color or smell, you should pay attention to the correct functioning of the entire body as a whole.

8–12 months before the appearance of menstruation, the girl’s body begins to undergo hormonal changes and the appearance of vaginal discharge is simply inevitable. These transformations are a sign that the body has switched from “girl” mode to “girl” mode. In this case, the discharge has a white or light yellow tint, a watery structure, with a weak sour odor or no odor at all. These secretions are considered normal, as they serve as a protective layer for the genitals from various types of infections, and as a lubricant for the vagina, unless accompanied by:

• itching;
• pain symptoms;
• burning sensation;
• do not lead to swelling of the external genital organs;

Discharge mixed with blood

Every woman has at least once wondered: is it possible to call such a phenomenon as spotting normal?

• 2–3 days before the start of menstruation;
• after menstruation (2–3 days);
• in the middle of menstruation while taking oral chemical contraceptives;
• in the middle of menstruation (during ovulation), if the discharge is moderate;
• after sexual intercourse, since the walls of the uterus may have minor damage;
• with the onset of sexual activity;

Bloody discharge from the female vagina is considered normal and is not related to any gynecological diseases only in the above cases. Other cases when spotting appears are an alarming sign of an imbalance in the female body.

Qualified medical assistance is required if:

• discharge lasting more than 3 days that is in no way related to menstruation, which appears in the middle of the menstrual cycle (excluding the option of taking hormones);
• discharge becomes regular every time after the next sexual intercourse;
• against the background of bloody discharge, body temperature rises, pain in the lower abdomen, itching, burning and dryness of the genitals appear;
• bleeding that appears after a delay in the menstrual cycle and instead of menstruation, as well as during pregnancy.

When is there no reason to worry?

When a woman notices spotting, the question immediately arises: what does this discharge mean? Don’t panic right away, because their nature can be completely harmless.

1. Before menstruation.
   Bloody discharge before the start of the menstrual cycle is a completely natural phenomenon. This discharge can be regarded as a warning sign before the start of the menstrual cycle. Typically, this discharge can be observed 2-3 days before the start of menstruation. If bloody discharge begins earlier than 3 days before the start of the menstrual cycle and is accompanied by painful stabbing sensations, these may be the first “bells” of adenomyosis. In this case, you should not neglect medical help.
2. After menstruation.
   Bloody discharge within a few days after the end of menstruation should also not be regarded as a sign of any disease. This is a completely normal phenomenon, since within 2-3 days, the uterus can thus remove the remaining menstrual blood.
   If this process lasts longer than 3 days, immediately run to the gynecologist, as this may be a sign of endometriosis, uterine fibroids, and adenomyosis. And if the discharge has a specific smell, this may be a symptom of chronic endometritis.
3. In the middle of menstruation.
   Bloody discharge in the middle of the menstrual cycle is considered normal only when a woman takes contraceptives orally; otherwise, this can only mean one thing: the inflammatory process is “activated” in the body.
   It could be:
   • disruption of the menstrual cycle;
   • infectious and inflammatory diseases (thrush, bacterial vaginosis, chlamydia, gonorrhea, etc.);
   • inflammation of the uterus and fallopian tubes;
   • benign and malignant tumors;

Does color matter?

Light spotting that occurs after sex may indicate problems with the uterus (cancer or cervical erosion).

If such discharge, accompanied by itching in the groin area, appears in a woman who is sexually active, it is worth thinking about external contraception. Discharge is a symptom of sexually transmitted diseases.

If light spotting occurs in a woman who does not use contraception, you should pay attention to the possibility of an ectopic pregnancy or miscarriage.

If the discharge is accompanied by a specific odor and pain in the lower abdomen, the possibility of chronic endometritis cannot be ruled out.

When turning to a gynecologist with a question about dark bloody discharge, a woman often hears that the shade of the discharge does not matter to the doctor, since its very presence should already cause alarm. Well, the color of this discharge depends solely on the amount of blood, which does not in any way affect the possible diagnosis. Therefore, there is no difference between dark and light bloody discharge.

Discharge instead of menstruation. What to do?

Gynecology explains the phenomenon of replacing menstruation with bleeding, based on the activity of a woman’s sexual life.

If you are sexually active this may mean that:

• You are pregnant;
• you have a hormonal disorder;
• you have a sexually transmitted infectious disease.

If you haven't had sex 1-2 months before your period or you have no sex life at all, the absence of periods and replacing it with discharge may indicate a hormonal disorder. The causes of imbalance may be:

• stressful state;
• rough physical activity;
• Gynecological causes cannot be excluded (sexually transmitted infections, ovarian cysts, adenomyosis, endometritis and endometriosis).

Also, spotting may foreshadow the gradual “switching off” of the reproductive functions of the female body (menopause).

If spotting bothers you and brings discomfort, it is best not to hesitate, but to go straight to the antenatal clinic to quickly identify and eliminate the cause of concern.

Red discharge from a woman’s genital tract is normal only during menstruation.

In other cases, as a rule, we are talking about some kind of pathology (with the exception of the scanty pink-red discharge that appears in some women at the time of ovulation). Therefore, the appearance of this symptom should serve as a signal for consultation with a gynecologist.

Causes of red discharge in women

The most likely causes of red discharge in a woman depend on her age. According to statistics, in young girls (aged 12-15 years) their appearance is most often due to functional hormonal disorders.

Over time, they lead to dysfunctional bleeding. In rare cases, the cause of spotting at a young age may be ovarian tumors that have hormonal activity.

For young girls with menstrual irregularities, an ultrasound examination is recommended.

During reproductive age, the list of conditions when red discharge (but not menstruation) appears expands.

A similar symptom may indicate a number of diseases:

• Uterine fibroids, especially its submucosal forms, disrupting the process of myometrial contraction;
• Cervical erosion (it can be caused by injury, infection and hormonal imbalance);
• (local growths of the inner layer);
• Ovarian cyst, accompanied by the formation of hormones that stimulate endometrial growth;
• Endometriosis, characterized by the presence of lesions in the body that undergo cyclic changes, like the uterus, which leads to the release of blood from them.

If red discharge appears in women over 45 years of age, this may be the first sign of a malignant tumor of the uterus or its cervix.

Only after neoplasms have been excluded can polyps and uterine fibroids be considered as the cause of bleeding. The reverse approach is incorrect, because can lead to diagnostic errors when serious life-threatening diseases are missed.

A similar principle is followed in women who have stopped menstruation (menopausal age).

What does their red discharge mean?

In this age group, the risk of cancer is even higher. Therefore, cancer of the uterus and its cervix is ​​considered the primary cause.

The second place is occupied by arterial hypertension, in which blood vessels are affected, and against the background of another increase in pressure, they rupture. This leads to bleeding during menopause in the absence of any gynecological pathology.

Quite often, women ask the question: “Why does red discharge after menstruation continue or appear again”? This causes them discomfort, incl. and in the intimate sphere.

The main reasons leading to prolonged blood loss are varied. They may be:

• (Asherman's syndrome, developing after curettage of the uterus);
• Chronic inflammatory process of the uterine mucosa (most often it is a consequence of urogenital infection and is manifested by red and white discharge due to the admixture of leukocytes in it);
• Endocervicosis (this is the second name for cervical erosion);
• Polycystic ovaries, characterized by increased production of testosterone;
• Hypothyroidism – decreased thyroid function is accompanied by persistence (long-term existence) of the corpus luteum.

Red discharge during pregnancy in most cases indicates a complicated course of pregnancy, which can pose a threat to the intrauterine fetus.

A variant of the norm is the appearance of so-called “implantation bleeding.” This is the presence of SCARY bloody discharge at the time of implantation of the egg into the endometrium.

This condition is not observed in all pregnant women. Often, when such a symptom appears, the woman does not even know that she is in an “interesting” position. Therefore, young patients with such complaints are recommended to take a pregnancy test.

Red discharge during early pregnancy may indicate a number of complications:

• Threat of interruption (miscarriage);
• Low location (in the area of ​​the uterine cervix) of placental tissue;
• Erosion on the cervix (in this case the risk to the fetus is minimal).

Bloody discharge in the second half of pregnancy is a sign of:

• Changes in the cervix that occur when there is a threat of premature birth;
• Detachment of normally located placental tissue;
• Detachment of the presenting (low-lying) placenta.

In addition to these reasons, bright red discharge seen on a pregnant woman’s underwear may be a consequence of hemorrhoids or an inflammatory process in the genitourinary system (urethritis, vaginitis).

To conduct a differential diagnosis, the gynecologist performs a vaginal examination and a number of additional examinations:

• Microscopy of vaginal secretion;
• General clinical urine analysis;
  A general clinical blood test to determine the level of hemoglobin (a low value indicates a chronic, recurring nature of blood discharge);
• Ultrasound examination assessing the length of the neck and its diameter.

Depending on the established diagnosis, further treatment is carried out.

If there is a threat of interruption, medications are prescribed that reduce the tone of the uterus and correct hormonal imbalances. Detachment of placental tissue requires the prescription of hemostatic and antispasmodic drugs.

Periodically bleeding erosion is not treated during pregnancy. Its treatment should be carried out 1.5 months after birth, when the cervix returns to its normal state after involutive processes.

Usually, either cryodestruction (exposure to low temperatures) or coagulation with electric current is performed. In pregnant women, exposure to these physical factors can negatively affect the development of the fetus.

When a woman discovers it in her underwear, she begins to worry about whether such a phenomenon is normal, or whether it is a sign of some pathology.

By nature, it can determine the presence of many diseases. Normally, the secretion that comes out of the vagina should be insignificant and transparent. Small white impurities are allowed, and 1 day in the middle of the cycle a drop of blood may be present in the discharge. All other situations indicate some kind of health problem. The nature of the discharge can be influenced by diet and bad habits. All this provokes negative processes in the body, which will certainly affect the state of the reproductive system.

A representative of the fair sex should take care of her health. Particular attention should be paid to the nature of the vaginal secretion. If any suspicious phenomena occur, you must consult a doctor and undergo an examination. Separately, it is worth mentioning the problem of red streaks in the discharge. This phenomenon does not occur often, but requires very careful attention. Blood in vaginal secretions may indicate some dangerous diseases, so such a signal from the body cannot be ignored.

Could this be the norm?

Most often, discharge streaked with blood indicates the development of certain pathologies in the female body. But it is also worth noting the moment when reddish streaks in the vaginal secretion are the norm.

We are talking about the process of ovulation. This phenomenon occurs in every representative of the fair sex once a month in the absence of pregnancy. This process occurs in the middle of the menstrual cycle. At the same time, during ovulation, a copious secretion occurs, which may be mixed with a little blood, which indicates the successful release of the egg.

Not all representatives of the fair sex note blood impurities in their skin, but most periodically encounter this phenomenon. This is not considered a deviation if there are few streaks of blood and the duration of unusual discharge is insignificant.

All other situations indicate the development of a negative process in a woman’s body. If red impurities are observed for more than a day, you must definitely consult a doctor and undergo a thorough examination.

Cervical erosion

One of the most common diagnoses received by representatives of the fair sex who are faced with the phenomenon of reddish streaks in the discharge is erosion. This is damage to the mucosa, which develops into an inflammatory process.

The peculiarity of this disease is that it does not make itself felt for a long time. The first symptom that a woman notices in the presence of erosion is pain during sexual intercourse. Blood in the discharge appears already at the stage when the disease reaches a high level of development. It is very difficult to treat cervical erosion in an advanced state, so when the first symptoms appear, you must consult a doctor. The gynecologist must conduct an examination on the chair. Using a mirror, you can immediately see the presence of an affected area on the mucous membrane.

During the examination, the doctor may see a red area of ​​irregular shape. There will be no epithelial layer on its surface. The eroded surface is quite bright in color, so it is impossible to miss it.

This area does not heal and is susceptible to injury. The integrity of tissues is especially often compromised during sexual intercourse. After this, representatives of the fair sex may notice mucous discharge with blood streaks. As a rule, impurities are noticeable for several days, and then disappear until the next sexual contact.

There are no other symptoms of cervical erosion other than unusual discharge and discomfort during intercourse. But it is necessary to treat such a disease, since an eroded surface can easily cause infection of the body. If the erosion becomes purulent, it will take a long and difficult time to treat. In this case, pain in the lower abdomen and increased body temperature will be added to the usual signs of the disease.

Erosion must be treated. An advanced disease can become an obstacle to pregnancy. If the disease is at an early stage of development, you can limit yourself to conservative methods and folk remedies. Advanced erosion requires surgery. Nowadays, laser, cryodestruction and radio wave therapy are used for these purposes. The disease must be treated carefully and carefully. Cervical erosion is prone to relapse, so all therapeutic measures must be agreed with a doctor.

The appearance of polyps

Another common reason for the appearance of blood streaks in the discharge is the presence of polyps. They can be located on the walls of the vagina. When such neoplasms are injured, there will be a slight bleeding.

As with erosion, bloody or brown secretion will occur mainly after sexual intercourse. In addition, bleeding can be caused by douching, gynecological manipulation and the use of tampons. As a rule, blood streaks are observed only 2-3 days after injury to the vaginal walls. Then everything goes back to normal until the next injury.

Polyps do not show their presence with any obvious symptoms, except pain during sexual intercourse and blood streaks in the discharge. But it is imperative to get rid of tumors. Otherwise, the woman runs the risk of getting a malignant tumor, since polyps can easily transform.

Therefore, before the disease reaches dangerous levels, it is necessary to get rid of polyps. For this purpose, a special operation is used, which is called polypectomy. To carry out the procedure for removing tumors, a laser, radio waves or a traditional scalpel can be used. For small polyps, cryodestruction, i.e. freezing, is suitable.

Other causes of symptoms

Cervical erosion and polyps are the diseases in which the most common symptom is slight red impurities in the vaginal secretion. There are other reasons, although they are much less common.

There can be many reasons for the appearance of blood streaks. These can be inflammatory processes in the reproductive system, and infectious diseases. Sometimes even sexually transmitted diseases lead to the appearance of blood impurities in the vaginal secretion. But in such situations, unusual discharge in women will be only one of many symptoms.

Vaginal mucus mixed with blood may also indicate a natural process that is not a cause for concern, but sometimes it becomes a sign of serious pathology. For example, if blood streaks are constantly present in the discharge, it is necessary to undergo a thorough diagnosis, including consultation with an oncologist. Blood impurities may indicate the development of a malignant neoplasm in the organs of the female reproductive system. The sooner the problem is detected, the higher the chances of curing this dangerous disease.

But streaks of blood in the discharge are not always a sign of pathology. For example, some women note a similar phenomenon during pregnancy. At the very initial stage, when a successfully fertilized egg is implanted into the uterus, vascular damage may occur. As a result, several droplets of blood are released, which are then mixed with vaginal secretions. Not every representative of the fair sex notes such phenomena upon successful conception, but still this cannot be called a rarity.

If such a nuisance as red streaks in the discharge appears, it is necessary to consult a doctor and undergo a differential diagnosis. The gynecologist will be able to determine the degree of danger and prescribe the most appropriate treatment for a particular case. Most problems that manifest as blood streaks in the discharge can be cured without surgery if you act on time.

Light spotting outside of menstruation or bleeding between periods is quite common. They occur in many women. Bloody discharge usually occurs before menstruation or a few days after it ends. However, they can appear on any day in the middle of the cycle. Most often, the nature of such discharge is normal and is not considered a symptom of any serious disease. But the causeless occurrence of profuse bleeding may be a sign of diseases of the uterus and other disorders of the female genital organs.

It is worth pointing out that the normal duration of the menstrual cycle is from 21 to 35 days, the duration of menstrual bleeding is 3-7 days, and blood loss ranges from 40 to 80 ml. Monthly blood loss of more than 50-60 ml contributes to acute iron deficiency in the female body.

Causes of bleeding in the middle of the cycle.
Intermenstrual bleeding refers to uterine or vaginal bleeding that occurs between menstruation, earlier or later than the expected start of menstruation. This phenomenon is also known as “vaginal bleeding between periods” and is expressed in the form of discharge of blood clots in the middle of the menstrual cycle. Some women attribute this phenomenon to a short cycle, but this is not true at all. A short cycle (polymenorrhea) involves severe blood loss that occurs on the 13th or 15th day after the end of the last menstruation. Such a phenomenon as polymenorrhea is usually observed when there is a disorder of uterine contractions in conditions of slow regeneration of the mucous membrane of its cavity, as well as blood clotting disorders. Therefore, this kind of phenomenon does not apply to polymenorrhea.

Intermenstrual bleeding most often occurs 10-16 days after the end of the last menstruation. This type of bleeding is not profuse (that is, you can get by with using “daily pills”) and lasts on average from twelve to seventy-two hours. If the intensity of bleeding does not change, then there is no reason to worry. If blood loss increases, and the duration of bleeding is more than three days, you need to visit a gynecologist. In case of severe bleeding, you should call an ambulance. It also happens that, having already become pregnant, a woman has her last menstruation, and she has absolutely no idea about conception. Therefore, in cases where such bleeding is accompanied by severe pain, suspicion arises of an ectopic pregnancy, miscarriage, etc.

Intermenstrual bleeding is observed in almost thirty percent of women and is normal. This phenomenon is caused by fluctuations in estrogen levels during ovulation, which cause the endometrium to weaken and bleeding occurs. Most often, in this situation, a woman is prescribed hormonal medications with estrogen to normalize hormone levels. Bleeding in the middle of the cycle is observed in women with frequent dysfunctions of the genitourinary system, and the nature of the bleeding is more intense.

There are two main types of bleeding that occur between periods:

• bleeding between two menstruation - intermenstrual bleeding;
• metrorrhagia - severe uterine bleeding.

• hormonal changes or disturbances in the body;
• insufficient amounts of thyroid hormones;
• miscarriage;
• diseases of the endometrium of the uterine cavity;
• use of intrauterine contraception (IUD);
• starting or stopping birth control pills;
• starting or stopping estrogen-based medications;
• severe depression or stress;
• cervical diseases;
• carrying out certain gynecological procedures (in particular cauterization and cervical biopsy);
• taking certain medications;
• vaginal infections or trauma to the vagina;
• benign neoplasms in the cervix, vagina or urethra.

In cases of intermenstrual bleeding, it is recommended to rest more and avoid stressful situations and depressive states in every possible way. Therapy for this type of bleeding is necessary if this phenomenon causes pain in a woman, and is also caused by the development of serious diseases. In these cases, appropriate treatment is prescribed.

To prevent the development of serious diseases, it is very important to visit a gynecologist if there is a constant delay in menstruation, with painful menstruation, with heavy or scanty bleeding during menstruation, or with irregularities in its duration. There is no need to despair if any pathology was identified during diagnosis, because treatment of the disease at an early stage is quite effective.

Bloody discharge in the middle of the cycle.
Bloody discharge that is scanty in nature (basically there is no need to use pads) occurs much more often than intermenstrual bleeding. They are expressed in the form of pinkish or light cinnamon mucus from the vagina, which can only be seen on toilet paper. Underwear does not get dirty.

This kind of discharge occurs approximately two weeks before the onset of menstruation and is completely normal. Basically, this period occurs during ovulation, so the discharge indicates the egg’s readiness for fertilization. Such selections help to determine as accurately as possible

Every girl - girl - woman from 11-15 years old to 45-55 years old has menstruation every month (excluding pregnancy and breastfeeding). Its normal duration is 3-7 days, blood loss during the entire menstruation is about 80 ml, the interval between menstruation is 21-35 days. This is a normal menstrual cycle.

If “women’s days” come irregularly, bleeding appears outside the cycle, namely before menstruation, after menstruation, in the middle of the cycle, critical days become excessively abundant and painful - this is a reason to consult a gynecologist-endocrinologist in order to find out the cause of such phenomena and selection of treatment.

CAUSES OF BLOODY DISCHARGE

1. Hyperplasia and endometrial polyps. With these diseases, heavy, painful menstruation is observed, sometimes with clots, as well as bloody intermenstrual discharge from the genital tract.

2. Uterine fibroids with submucosal nodes. This disease is characterized by cramping pain in the lower abdomen and lower back during menstruation, which becomes protracted and profuse.

3. Endometriosis. Spotting and spotting for several days before and after menstruation, painful menstruation with clots most often indicate the presence of endometriosis.

4. Ovulatory syndrome. Some women note the appearance of vaginal spotting and/or pain in the lower abdomen in the middle of the menstrual cycle on the days corresponding to ovulation.

5. Trauma to the genital organs and problematic defloration. There is a characteristic connection between rough, violent sex and subsequent bleeding from the genital tract. Most often, vaginal ruptures and rupture of the posterior commissure occur, for example, during forced or persistent defloration. In some situations, such injuries require surgical treatment.

6. Dysfunctional uterine bleeding. After a period of delayed menstruation, very heavy, painless menstruation comes, which does not end on its own, but turns into bleeding. At the same time, the woman’s general condition worsens due to blood loss, and anemia occurs.

7. Insufficiency of the second (luteal) phase of the menstrual cycle. If, after ovulation, an incomplete corpus luteum has formed that produces an insufficient amount of hormones, a few days before the next menstruation, dark bloody discharge from the vagina appears. This situation can occur only in one menstrual cycle, or can be repeated monthly.

8. Cervical and endometrial cancer. These diseases are characterized by bloody vaginal discharge of varying intensity, not associated with the phase of the menstrual cycle.

9. Cervical erosion. Cervical diseases are characterized by contact discharge from the genital tract, that is, resulting from contact of the cervix with the penis during sex, with a gynecological speculum during a medical examination, as well as with constipation.

10. Endometritis. Inflammation of the uterine mucosa is often accompanied by prolonged menstruation and bloody intermenstrual vaginal discharge.

POSSIBLE INVESTIGATION METHODS

BLOODY DISCHARGE DURING PREGNANCY

Discharge of blood from the vagina in the first half of pregnancy most often indicates a lack of the hormone progesterone. It is often accompanied by nagging or cramping pain in the lower abdomen and lower back. If you do not pay attention to this, then everything can end in a spontaneous miscarriage. The period of bearing a child requires a particularly careful attitude of the expectant mother to her body. During an ectopic pregnancy, a woman may also experience bleeding from the genital tract.

The phenomena described above during this period may signal one or another problem, which only a doctor can understand. Make an appointment with a gynecologist-endocrinologist at our clinic and undergo the necessary examination as soon as possible. This is especially necessary in the presence of bloody discharge.