SEXUALLY TRANSMITTED INFECTION SYMPTOMS IN WOMEN: BLEEDING BETWEEN PERIODS
Bleeding between periods (called irregular bleeding) is not unusual and may be related to a sexually transmitted infection. (Sometimes irregular bleeding is the only symptom of a sexually transmitted infection.) Some of the common causes of bleeding between periods are listed in this chapter. An examination is necessary to explore all of the possibilities and rule out infection as a cause.
Anovulation. The occurrence of a menstrual period, or uterine bleeding, each month is the result of a complex interplay between signals from the brain and the pelvic organs. The lining of the uterus (the endometrium) builds up each month in anticipation of the implantation of a fertilized egg. If a fertilized egg is not implanted, the lining is shed during the woman’s period. Many women, at some point in their lives, experience irregularity in their cycles. Certain women have irregular periods from the time they start menstruating. Others normally have regular periods and then occasionally miss a period. The most common cause of the latter event is anovulation, when the signals between the brain and the ovaries “misfire” and an egg is not released from the ovary in the middle of the cycle. If an egg is not produced, there may also be gradual shedding of the lining of the uterus throughout the cycle, rather than a full shedding at the end of the cycle. Usually, the cycle picks up the next month where it would have had an actual period occurred. But if the periods do not resume, an evaluation to determine the underlying causes is necessary.
Bleeding disorders. Blood clots as the result of a complex interplay between cells in the blood and components called clotting factors. Any underlying medical problem that disrupts this relationship may cause unusual bleeding from any place in the body, including the vagina. Often, but not always, there will be unusual bleeding from other areas as well.
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