Bleeding Between Periods

What Causes Bleeding Between Periods?

Bleeding between periods can have various causes, ranging in severity from 'troubling' to 'generally fatal'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose bleeding between periods, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "bleeding between periods" as a symptom.  Here are eight of many possibilities (more below):
  • Ovarian Cancer
  • Low Progesterone
  • Ovarian Cysts
  • Hypothyroidism
  • Fibroids
  • Adrenal Fatigue
  • Endometriosis
  • Endometrial Hyperplasia

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
brittle hair
uterine fibroids
macrocytic red cells
breast soreness during cycle
intermittent abdominal fullness
regular unexplained nausea
very low free T4
non-human estrogen use
unexplained missed periods
premenstrual weight gain
darker/redder skin color
history of painful menstrual cramps
... and more than 140 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of bleeding between periods:
Cause Probability Status
Ovarian Cancer 92% Confirm
Low Progesterone 20% Unlikely
Hypothyroidism 13% Unlikely
Endometriosis 4% Ruled out
Ovarian Cysts 2% Ruled out
Fibroids 1% Ruled out
Adrenal Fatigue 0% Ruled out
Endometrial Hyperplasia 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate being premenopausal or being perimenopausal, The Analyst™ will ask further questions including this one:
Do you have bleeding between periods?
Possible responses:
→ Don't know
→ No
→ Occasionally / moderately
→ Often / severely
Based on your response to this question, which may indicate either absence of bleeding between periods or bleeding between periods, The Analyst™ will consider possibilities such as:
Endometrial Cancer

The most common sign of endometrial cancer is unusual bleeding from the vagina, especially bleeding that occurs after passing through menopause.


Prolonged and/or heavy periods are a sign of hypothyroidism.

Ovarian Cysts

Ovarian cysts may cause a variety of menstrual abnormalities, including Metrorrhagia, depending on the hormone produced by the cyst.  Metrorrhagia can also be a result of an ovarian cyst being unusually large, blocking the blood supply or rupturing.

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