It is common for females who are first starting puberty or approaching menopause to have abnormal bleeding or spotting. In addition, women who have relatively normal cycles may experience an abnormal period from time to time, due to stress or illness. Abnormal bleeding and spotting may last no longer than a day, but for some, it may last for months.
Normal Menstrual Cycle
During a normal menstrual cycle, the pituitary gland releases two hormones, luteinizing hormone and follicle-stimulating hormone. The release of these hormones causes the ovary to produce the female hormones estrogen and progesterone, which cause the uterine lining to shed and bleed. This bleeding is called a "period." Period bleeding lasts anywhere from three to seven days. Midway through the menstrual cycle, the ovary releases an egg, and the uterine lining thickens again in anticipation of a pregnancy. If pregnancy is not achieved, the entire cycle begins again. According to Merck, normal menstrual cycles last anywhere between 25 to 36 days.
Identification
Bleeding that lasts longer than seven days or is heavier in flow, accompanied by pain, contains large blood clots or is more frequent, less frequent or absent, but with spotting, is considered abnormal. At some point in their lives, most women experience abnormal bleeding or in-between spotting; it is perfectly normal.
Causes
Abnormal menstrual periods or bleeding in between periods (spotting) is normally a result of irregular hormone levels. Changes in the hormone levels can be a result of taking birth control pills, using an intrauterine device (IUD), taking low-dose hormone pills or having a medical condition such as polycystic ovary syndrome. Polycystic ovary syndrome causes the pituitary gland to release too much luteinizing hormone; in return, the ovary releases an imbalanced amount of these hormones and an excess of male hormones. This will cause a woman's periods to become too frequent and too heavy, or she may even bleed in between periods. In addition, abnormal bleeding and spotting can occur during peri-menopause, which generally occurs five to eight years before menopause begins. During this time, the hormone estrogen begins to fluctuate, which causes abnormal bleeding.
Treatments
The causes of the abnormal bleeding and spotting should be investigated and treated. In some cases, doctors choose to monitor the situation in hopes that the bleeding will subside on its own. In other cases, the doctor may prescribe birth control pills or other hormone replacements to regulate hormone levels. In more severe cases, the woman may need surgery or the use of stronger medication.
Warnings
Bleeding lasting more than seven days that is accompanied by pain or a heavier flow than usual should be reported to a physician immediately. Passing blood clots can be normal; however, if the blood clots are frequent and larger than a quarter in size, this should be reported as well.
