Causes of bleeding in between cycles

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting. There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle. A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such PCOS and Endometriosis, but these disease states can be treated and managed to give women a normal life. Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, acupuncture, herbal medicines, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a specialist if you have abnormal bleeding.

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

 

What causes a burning sensation in the vagina and around the vulva?

A burning sensation in and around the vaginal, vulva area is a relatively common complaint that many women experience and something that is seen in practice very often. There are so many different causes of vaginal and vulva burning, including irritants, sexually transmitted diseases, atrophic vaginitis, thrush, lichen sclerosis, climates changes and is very common in peri-menopause and the menopause period. Each of the causes has its own set of symptoms and the treatments can all vary, depending what the cause it.

In this article we will look at the common causes of having a burning sensation in the vagina and around the vulva area. We will also look at treatments and management of these as well.

Before we start, it is important that women know that often people use the wrong term for the vagina and the surrounding area and often refer to a woman’s genitals as just being the vagina. It is important that we use the correct terms for a woman’s anatomy so that we can correctly identify were problems are.

The vagina is more the internal part of the female genitals and the vulva is the external part. Th Vulva is an umbrella term for the various parts of the external female genitals. These parts include:

  • Mons pubis – the fatty ‘pad’ that’s covered in pubic hair
  • Labia majora – outer lips
  • Labia minora – inner lips
  • Clitoris – small organ that’s packed with nerve endings
  • Urethral opening – which allows the passage of urine
  • Vestibule – area around the opening of the vagina
  • Perineum – area between the vagina and anus

Now that we understand the proper terms for the anatomy, lets have a look at what some of the common causes of burning sensation are.

Common causes of vaginal and vulva burning sensation

1.Skin Irritation

There are many things that can irritate the skin of the vulva and vagina when they come into direct contact with it. This is known as contact dermatitis.

Irritants that can cause contact dermatitis, inflammation and burning symptoms include non pH neutral soaps, certain fabrics, perfumes, vaginal hygiene sprays, some lubricants and allergens. As well as burning sensations, women may experience the following:

  • severe itching
  • redness and rawness and sometimes bleeding
  • stinging feelings and sensations of heat
  • pain and sometimes

The main way to treat irritation is to avoid whatever has caused the irritation in the first place. Avoiding the irritant and allowing the inflamed area and the skin to heal is one of the best things to do. Sometimes, a woman may require medications to settle the inflammation, or dermatitis down.

2. Candidiasis (Thrush, Yeast infections)

An overgrowth of bad bacteria in the vagina can lead to a burning, stinging sensation and one of the common causes of issues for women. Candidiasis, or thrush is very common in women and is causes through changes in the gut and vaginal flora and this then leads to overgrowth of bacteria, which causes many of the following symptoms

  • itching
  • soreness
  • pain during sex
  • pain or discomfort when urinating
  • discharge from the vagina (either white, or coloured)

Women are more likely to be prone to getting thrush if they are taking antibiotics, using certain form of hormones and contraceptives, have a weakened immune system, live in humid climates, have diabetes, are pregnant, or not cleaning themselves properly. High stress can also lead to changes in the gut and vagina flora and this can also lead to thrush.

Thrush is usually an antifungal medicine called azoles. Azoles can either be used internally into the vagina, or taken orally as a capsule, or both at the same time. Pre and Probiotics should be taken to help build up the good bacteria and women should take care with personal hygiene. Partners may also need to be treated to prevent further reintroduction of thrush via sexual intercourse.

3. UTI- Urinary tract infection

When a woman has a urinary tract infection (UTI), she will be likely to feel burning in and around the vagina when urinating. There may be other presenting symptoms such as:

  • needing to urinate more frequently, or have urgency to urinate
  • pain with urination
  • smelly, or cloudy urine
  • blood in urine
  • pain in lower stomach and radiating pain into the back and kidney area
  • feeling tired or unwell

When a woman has a urinary tract infection antibiotics will be needed and the antibiotics needed will depend on what the cause of the infection is. Usually an infection will clear up in around 5 days after starting a course of antibiotics.Repeat medication may be required if an infection returns.

4. Bacterial Vaginosis (BV)

Bacterial Vaginosis (BV) is the most common vaginal infection in women aged 15 to 44. Bacterial Vaginosis (BV) is a condition that occurs when there is too much of certain kinds of bad bacteria in the vagina, affecting the balance of good bacteria and flora. One of the main symptoms of BV is a burning sensation in the vagina, which can also occur when urinating.

BV does not always cause symptoms but when it does cause symptoms, besides a burning sensation, it can cause the following:

  • white or gray vaginal discharge
  • pain and irritation
  • itching and redness
  • strong fish-like odor, especially after sex (one of the key symptoms)

Having BV can increase a woman’s risk of STI’s and it can also increase her risk of miscarriage, once she is pregnant. If you think that you may have the symptoms of BV, you need to have it check by your doctor as soon as possible. BV is usually treated with antibiotics and you can use complementary medicines to assist in the treatment as well. It is a good idea to restore the good bacteria into the gut and vagina as well. This can be done through the use of prebiotic and probiotic bacteria combined.

5. Trichomoniasis

Trichomoniasis is a common STI and is caused by a parasite that is passed from one person to another during sexual intercourse. Many people may not know that have Trichomoniasis, but symptoms can present with a burning sensation and may  also present with  the following:

  • itching, redness, or soreness
  • discomfort when urinating
  • women can have vaginal discharge that can be clear, white, yellow, or green and with a fishy smell

Trichomoniasis can increase a woman’s risk of miscarriage, so it need to be treated asap. Trichomoniasis is treated by using certain forms of medicines called azoles.

6. Gonorrhea

Gonorrhea is an sexually transmitted infection where bacteria called Neisseria gonorrheae infect mucous membranes, such as the cervix, uterus, and fallopian tubes. If a woman is infected with gonorrhoea she can experience vaginal burning when urinating, as well as the following symptoms:

  • pain when urinating
  • vaginal discharge
  • vaginal bleeding between periods

Gonorrhea can be cured with the right medical treatment and it needs to be treated with specific medications. Often dual forms of medication are used for effective treatment.

7. Chlamydia

Chlamydia is a common STI caused by the bacteria Chlamydia trachomatis and is  transmitted through sexual intercourse with someone who has the infection.

If a woman comes in contact with chlamydia through intercourse, many times she may be asymptomatic (meaning no symptoms) and this is why it is often known as a silent infection. When symptoms do occur it can cause a burning sensation in the vagina and surrounding area. There can be other symptoms which include:

  • increased vaginal discharge
  • pain with urination and pain during sex
  • bleeding during sex and between periods

Chlamydia can cause damage to a woman’s reproductive organs and can affect her fertility, so it is important to have this treated as soon as possible.  Chlamydia is treated using specific high dose antibiotics. Treatment may also require IV antibiotics and for someone to be admitted to hospital while these are being administered.

8. Genital herpes

Genital herpes is a common sexually transmitted disease caused by skin-to-skin contact with a person with the herpes virus. Once a person has the virus, it stays with them for life. Sometimes the virus can remain dormant and then at certain stages of life (during stress, illness etc), it can become active and start producing symptoms.

If the virus becomes active, they might experience a burning sensation in the vagina, along with some of the following symptoms:

  • an itching or tingling sensation
  • flu-like symptoms
  • swollen glands
  • pain in the vaginal area, particularly when urinating
  • change in vaginal discharge

Painful sores, blisters, or ulcers may also develop after a few days. The symptoms of genital herpes can be treated with antiviral medication but once you have herpes, it cannot be cured. You just need to manage it and its symptoms.

9. Lichen sclerosus

Lichen sclerosus is a skin condition that affects the vulva area in women. Lichen sclerosus can cause burning sensation around the vulva area. It can also cause the following symptoms:

  • itching and tenderness.
  • Pain
  • Scarring
  • Wrinkling and white patches

Postmenopausal women are most susceptible to have lichen sclerosus. The cause is thought to be an autoimmune response of some kind, since the condition is associated with autoimmune disorders such as Graves’ disease and vitiligo. Treatment includes topical steroid creams, other medications, silica cream, zinc cream and regular medical monitoring. Lichen sclerosus is linked to an increased risk of vulvar cancer.

10. Menopause

Vaginal and vulva burning can be as a result of the perimenopause, or menopause stages of life. The shifting levels of hormones in a woman’s body before she enters menopause can affect the vagina and surrounding area. Burning sensations, in the vagina and around the vulva area is one possible result of these changes, especially during sex.

Some of the common symptoms of the perimenopause/menopause period are:

  • hot flushes & night sweats
  • difficulty sleeping
  • reduced sex drive
  • vaginal dryness
  • headaches
  • mood changes
  • Pain with sex
  • Atrophic vaginitis.

Not all women entering menopause have treatment to relieve symptoms, but there are often options available that a doctor, or healthcare practitioner, can outline, including hormone therapy. There are also many natural therapies that can help during peri-menopause and menopause stages of life.

What you can do to help yourself

Many causes of vaginal burning require medical treatment. If you are concerned, the best you can do is to see your healthcare practitioner. There are things you can do before seeing your doctor. Sometimes a ice pack or cold compress to the affected area can help reduce the burning sensation. You can also try some over the counter soothing creams, or antifungals.

Make sure you are practicing proper hygiene and cleaning the outer area of the vulva properly. Women should avoid using douches, which can affect the good bacteria and internal flora of the vagina.  Wearing cotton underwear and avoiding tight-fitting clothes can help reduce irritation in the vaginal area. It is also important to avoid products that could irritate the area further, such as perfumed soap, scented toilet paper, and sanitary products with deodorant, or a plastic coating.

Possible complications

Some causes of vaginal burning, such as urinary tract infections, BV, STI’s, lichen sclerosis can have some serious complications if left untreated. Cancer also needs to be ruled out so this is why it is important to have any symptoms of burning checked out by your doctor.

STI’s can affect future fertility and are also harmful to women who are pregnant, as they can affect their baby, or pregnancy. Many STI’s can cause preterm delivery and also increase the risk of miscarriage.

While some causes of vaginal and vulva burning may go away on their own over time, it is still important to go and get your doctor’s advice just to be safe. If your symptoms aren’t going away, are becoming worse, or are of a concern, then the woman should go and see a doctor as soon as possible. The longer you leave something, the worse it can get and the more issues it can cause, if left untreated. Many of the cases of burning sensation in the vagina and around the vulva will be relieved once the underlying cause is treated properly and with the appropriate medicines.

While medical options will be needed for some conditions, there are complementary medicines and complementary medicine modalities that may be able to assist your particular issue, or alongside medical treatments. Please always see a qualified healthcare practitioner and not use Dr Google, or take advice from friends or family for any medical advice.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

Blue Berries Help To Fight Cervical Cancer & Enhance Medical Treatments

Researchers have shown that combining blueberry extract with radiation may be the next treatment in the war against cervical cancer. Plus, Blueberry extract also offered normal cell protection from the radiation at the same time

Worldwide, cervical cancer is the third most common cancer among women and the second most frequent cause of cancer-related death, accounting for nearly 300,000 deaths annually. In developing nations, it is often the most common cause of cancer-related death among women and a leading cause of death overall.

One of the most common treatments for cervical cancer is radiation. While radiation therapy destroys cancer cells, it also destroys nearby healthy cells. University of Missouri School of Medicine researchers studied in vitro human cancer cells to show that combining blueberry extract with radiation can increase the treatment’s effectiveness.

When Radiation therapy is needed it uses high-energy X-rays and other particles such as gamma rays to destroy cancer cells. For some cancers, such as late-stage cervical cancer, radiation is a good treatment option. However, collateral damage to healthy cells always occurs. Because of the damage to healthy cells researchers studied blueberry extract to verify if it could be used as a radiosensitizer.

Radiosensitizers are non-toxic chemicals that make cancer cells more responsive to radiation therapy. In a previous studies research has shown that resveratrol, a compound in red grapes, could be used as a radiosensitizer for treating prostate cancer. It is also know that Blueberries also contain resveratrol. In addition to resveratrol, blueberries also contain flavonoids, which  are chemicals that may have antioxidant, anti-inflammatory and antibacterial properties.

The researchers used human cervical cancer cell lines to mimic clinical treatment. The cell lines were divided into four groups that included a control group, a group that received only radiation, a group that received only blueberry extract, and a group that received both radiation and the extract.

Researcher found that on its own, radiation decreased cancer cells by approximately 20 percent. Interestingly, the cell group that received only blueberry extract had a 25 percent decrease in cancer. However, the biggest decline in cancer cells occurred when the radiation was combined with the blueberry extract. There was a 70 percent  decrease in cancer cells in the group the blueberry and radiation group.

The other interesting observation was that the blueberry extract also reduced the abnormal explosion of cell growth, which is what cancer is. While the blueberry extract inhibits the birth of cancer cells it also tricks the cancer cells into dying. So the extract inhibits the borth and promotes the death of cancer cells.

Blueberries are an amazing food source with antioxidant properties and many health benefits. They are also found all over the world and it is great to see this super food doing a super job of boosting the effectiveness of existing medical therapies to save women’s lives around world.

Regards

Dr Andrew Orr

-No Stone Left Unturned