In an ideal world, women would bleed from their vagina on a completely predictable schedule. (Well, okay, not really, but you know what we mean – in an ideal world of .) In fact, discovery and breakthrough bleeding are extremely common.
There are many things that can cause you to bleed out of the cycle and many of them are not something you should make fun of. For example, spotting often refers to early pregnancy or birth control pills, and it is usually harmless, as Jacques Moritz M. D., an Ob / Gyn at New York Presbyterian and Weill Cornell Medicine, tells SELF. However, sometimes a breakthrough bleeding can be an indication of a medical problem requiring assessment and treatment.
Therefore, we will make the general recommendation that if you see bleeding between periods and between periods you do not know exactly why – especially if it is new or accompanied by pain or other symptoms – you are should contact your family doctor or ob / gyn so they can find out what's going on. In any case, here are some of the common reasons why people experience bleeding and breakthrough bleeding.
. 1 You have recently started a new contraceptive birth control pill.
Spotting in the first three months after taking a new Birth Prevention Pill is a matter of course for the course, says dr. Moritz. "It can take three months for your body to get used to the drug and the endometrium to adapt to it."
Spotting can also occur when you switch from a brand name to a generic, Dr. Moritz. Gynecologists suggest that generics may not match perfectly with brand name formulations, and that the small difference may be sufficient to cause breakthrough bleeding. The FDA says that all generics work like their brand names, but allow for a slight, natural variability. (However, this does not change the main function of the medicine.) If you are still speculating after three months of a new pill or are suddenly starting to discover your current pill, ask your ob / gyn after changing the medication.  2. You take a pill with a very low birth control dose.
Many of the newer generations of low-hormone pills either have very little estrogen or no estrogen at all and are mostly dependent on progestin to regulate their cycle. While many people like these formulations because they have fewer side effects, the extremely low dosage makes breakthrough bleeding more likely, even if you have been using the same pill for a while. "The pill makes the uterine lining so thin that the small blood vessels are fragile and only break because they do not have enough hormones to support them," explains Dr. Moritz. If the stain bothers you, ask your ob / gyn if you would like to change to a higher dose pill.
You have an IUD.
Similar to the pill, a hormonal IUD may first cause a breakthrough bleeding – up to three to six months after onset. When it comes to copper IUD, irregular bleeding (and stronger, more painful periods) is relatively common and can last quite a while. As SELF has already reported this is because the device can irritate and inflame the uterus. Although doctors generally recommend giving your body about six months to adjust, talk to your gynecologist if you feel bad.
. 4 You have an STI.
While gonorrhea and chlamydia are usually asymptomatic – one of the reasons why a regular STI exam is so important – they may both (together with other symptoms) cause vaginal bleeding) especially if the infection is left untreated and can spread throughout the reproductive system. Endometritis (inflammation of the endometrium) and cervicitis (inflammation of the cervix) may occur, as well as pelvic inflammatory (PID), which can cause complications such as permanent damage to the fallopian tubes and fertility problems . (Although gonorrhea and chlamydia are the most common infections associated with PID, Mayo Clinic  may also cause other types of bacteria.)
5. You are about to get pregnant.
Implantation Bleeding is one of the first signs of pregnancy occurring in up to 25 percent of women, according to the American College of Obstetricians and Gynecologists (ACOG). One to two weeks after fertilization, when the fertilized egg is implanted in the lining of the uterus, very little blood can flow from the uterus and vagina. "It's just a small place, not much," says Dr. Moritz. You can also experience cramping.
. 6 They are pregnant and have a subchorionic hematoma or bleeding.
This is essentially a blood clot that can occur when the outermost membrane surrounding the embryo (the chorion) separates slightly from the uterine wall, allowing some blood to collect in the space between the two. Sometimes this blood flows from the vagina, but sometimes not. In any case, it is painless and very common, says dr. Moritz. Normally, everything is fine, although depending on factors such as the size of the hematoma, the age of the mother, and the age of the fetus, they may sometimes have a slightly higher risk of miscarriage, says Dr. Moritz.
. 7 They had vaginal intercourse during pregnancy.
During pregnancy "the cervix becomes very sensitive, and if the penis touches it, it can bleed heavily," says Dr. Moritz. According to ACOG more blood vessels develop there, so that bleeding after intercourse is no big deal. "It's fine," he assures. That does not mean that something has happened to the baby – a penis can not really pass the cervix and harm the fetus.
. 8 You have a miscarriage or an ectopic pregnancy.
Although bleeding during pregnancy is common and usually harmless, especially in early pregnancy, there are some worst-case scenarios that you should keep in mind. Bleeding is the first sign of a miscarriage Moritz, which occurs in about 10 percent of known pregnancies, according to ACOG . It can also lead to convulsions.
Bleeding is also the first sign of ectopic pregnancy, as reported by SELF . It occurs when the egg is implanted somewhere other than in the uterus, almost always in the fallopian tubes. While ectopic pregnancies are rare, they can be life-threatening if the tube ruptures, so seek medical attention immediately so they can create a sonogram.
. 9 You have ovulation.
Some women experience during ovulation, as the downturn in hormones can cause a small uterine mucus to break down too early, as [SEL] previously reported leading to minor bleeding. If your mid-cycle bleeding is accompanied by one-sided pain, you may have moderate pain . This type of ovulation pain occurs when the follicle breaks and releases its egg, according to the Mayo Clinic .
10th They are perimenopausal.
Changes in your menstrual cycle are the hallmark of your body being close to menopause. The phase before menopause, called perimenopause may last for several years as hormone levels gradually shift, according to ACOG . Along with periods that are lighter or heavier, shorter or longer, more or less frequent, there may be breakthrough bleeding during hormone dips.
. 11 You have a gynecological cancer.
Although many women with gynecological cancer, especially early on, show no symptoms, abnormal vaginal bleeding is often one of the first signs that you have [cervical cancer] cervical cancer ovarian cancer uterine, vaginal or vulvar cancer the CDC . Although cancer is unlikely, it is a good idea to see your doctor to rule it out. This is especially true if you are postmenopausal. Moritz, because common causes of bleeding such as pill or pregnancy are off the table, which increases the likelihood that it could be cancer. "Every time after the menopause must be examined," he says.
12th They do not have cancerous growths on the ovaries, uterus or cervix.
There are a number of abnormal, but usually benign growths that can occur on your reproductive organs, including ovarian cysts uterine fibroids uterine / endometrial polyps and cervical polyps , With all of these, local pain can be mixed to varying degrees, even if other symptoms occur. And bleeding does not necessarily occur in all. For example, it is much more common to see bleeding with endometrial polyps than with ovarian cysts, says dr. Moritz.
Although bleeding from any of these growths is fairly normal, your doctor may wish to perform tests or remove them, even if they do so are benign because they can cause complications in addition to pain and other symptoms, such as fertility problems .