What causes bleeding between periods - intermenstrual bleeding - IMB

Purpose:

Multiple trials by the World Health Organization have established levonorgestrel as the gold standard in hormonal emergency contraception (EC). However, changes in menstrual patterns following EC have been observed; thus, we undertook this prospective study to identify and determine the characteristics of these changes. MATERIALS: Women re questing EC at either any of two hospitals --1 family planning unit and 12 pharmacies in Yaoundé, Cameroon were enrolled if they had a history of regular menstrual cycles over the previous 3 months and if they agreed to follow-up until the end of the subsequent menstrual cycle. Pretreatment menstrual patterns were compared with those of the EC treatment cycle and the cycle after EC.

Results:

In a set of 232 participants (mean age, 25 years), we observed 34 (14.7%) cases of incident intermenstrual bleeding and statistically significant changes in menstrual cycle length, menstrual period length and menstrual appearance compared to baseline patterns that differed according to whether EC was taken well before, close to or well after the expected ovulation for that cycle. The majority of these changes disappeared in the following cycle.

Conclusion:

Levonorgestrel EC is associated with significant but transient changes in menstrual patterns in a significant proportion of users.

Please click on the required question.

• 1 Are heavy periods a common problem?
• 2 What is in my menstrual flow?
• 3 What range of menstrual cycle length is considered to be normal?
• 4 How can menstrual blood loss be measured?
• 5 How can I tell if my periods are abnormally heavy?
• 6 What could be the cause of my very heavy menstrual periods?
• 7 I have been sterilised. Could this be the cause of my heavy periods?
• 8 Should I have tests to find the reason for my heavy periods?
• 9 How will my heavy period problems be investigated?
• 10 What is meant by anaemia due to heavy periods?
• 11 What is intermenstrual bleeding?
• 12 What is a hysteroscopy and D and C?
• 13 What is cervical cautery?
• 14 What happens after the D and C?
• 15 What treatments are available for my heavy periods?
• 16 What are the medical treatments available for heavy periods?
• 17 How do the various medical treatments for heavy periods work?
• 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
• 19 What is a hysterectomy?
• 20 What are the indications for hysterectomy?
• 21 What are the risks (complications) of hysterectomy?
• 22 What is vault granulation?
• 23 What are the different types of hysterectomy?
• 24 Is it essential to remove the neck of the womb at hysterectomy?
• 25 Should my ovaries be removed or conserved during hysterectomy?
• 26 How long will I be in hospital when I have my hysterectomy?
• 27 I have had a hysterectomy. Do I still need to have smear tests?
• 28 What are the other surgical alternatives to hysterectomy?
• 29 How do endometrial ablation and hysterectomy compare?
• 30 Are there any psychological effects following hysterectomy?
• 31 How do we decide the best treatment for my period problems?
• 32 Could I have some recommended hysterectomy support groups?
• 33 Are there any support groups?
• Intermenstrual Bleeding - Bleeding between periods.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.