Spotting Week After Period

Spotting Week After Period

What is spotting? Common causes and how to track it

Light bleeding, on the other hand, is a slightly heavier form of bleeding than spotting. You may need to use menstrual products, like a tampon, pad, or a higher absorbency panty liner (8).

21 reasons why you may be bleeding between periods

Bleeding between periods can be both frustrating and concerning. More often than not however, spotting is not indicative of a serious medical issue. Noting the timing of the spotting, how long it lasts, and other relevant details such as blood colour and consistency, can help determine what’s causing it. It’s not always clear when you are spotting – to identify the difference between that and menstrual bleeding, check out our guide to spotting vs menstrual bleeding .

We’ve identified 21 reasons for breakthrough bleeding, from most common to rare and potentially life threatening. As always, if you are concerned about anything you read, please seek professional medical advice.

1. It’s Your First Ever Period

For many girls, the first few years of menstruating are a confusing and unpredictable haze of painful and irregular menstrual cycles. Spotting during this time is normal, whilst the reproductive system figures out the nuances of menstruation.

2. Contraceptives

Spotting is a common and normal side effect of starting, stopping, or switching birth control medications. Oestrogen helps keep the lining of the uterus in place. Changing the oestrogen or progesterone levels in your body as a result of varying birth control use could lead to spotting in between periods. This is usually just a short term side effect in the first three to six months, as your body adapts to changes in hormone levels. This is also true of all hormonal contraceptives, including the oral contraceptive pill, artificial progesterone injections, intrauterine devices (IUD) or the implant. Unscheduled bleeding is a common side effect of hormonal contraception, especially during the first few months of starting a new method.

If you’re taking combined oral contraceptives (the most common type of birth control pill), and the spotting continues after the first few months, you may want to try another brand with a different level of oestrogen. Additionally, continued spotting is more common with the hormonal IUD and the mini-pill (a progestin-only pill).

3. Ovulation Spotting

A. You Have a Decline in Oestrogen

One out of ten women experience light spotting during ovulation in their menstrual cycle because of a brief decline in oestrogen levels that occur when an egg is released from an ovary. Spotting can also occur due to reduction of the level of oestrogen which usually precedes ovulation. The decline in oestrogen causes women to experience brown vaginal discharge, or spotting, as well as cramping and discomfort.

B. Ovulation Pain

When an ovary releases an egg, some women experience one-sided, lower abdominal pain or mittelschmerz (German for ‘middle pain’). This usually occurs about fourteen days before your next period. Aside from mild pain, mittelschmerz can cause spotting. It is important to note that ovulation is when you are most fertile. Be sure not to mistake this type of spotting with menstrual bleeding!

C. You Have a Delayed or Partial Period

During a ‘normal’ period, menstrual blood consists of old blood, endometrial lining and dead tissue. When you have a delayed or partial period, small amounts of lining are left behind inside the uterus. When this remaining tissue finally expels, it takes the form of brownish discharge or blood.

4. You Have a Slow Thyroid

Hormonal imbalances are one of the primary reasons for vaginal spotting between periods. A slow thyroid (hypothyroidism) is characterised by hormonal imbalances, and therefore has a significant effect on a woman’s menstrual cycle.

5. You Have a UTI

Urinary Tract Infections (UTIs) can cause bleeding from the urethra. If you are finding it painful to urinate, and seeing a small amount of blood, a UTI could be the cause. Most UTIs are easily treated with a full course of antibiotics, as prescribed by your GP.

6. Certain Medications

Anticoagulants or blood thinners are drugs that help prevent your blood from clotting or prevent existing clots from growing. One side effect of taking these drugs is unusual bleeding, either before your period or excessively during your period. Some antipsychotic and antidepressant medications which affect serotonin uptake can also cause spotting in women

7. You’ve Taken the Emergency Contraceptive Pill

Emergency contraception, or the morning after pill, can cause light spotting. Although it is not a side effect, the medication’s hormones can cause bleeding. Whilst this is completely normal, it is important to note that this does not indicate you have had your period, and therefore does not signify you are not pregnant. Usually when you’ve taken emergency contraception, you’ll get your period sooner than scheduled. It is also common for the second cycle, and period, to be slightly longer.

8. A Vaginal Injury

Inserting something into your vagina such as a tampon, penis or sex toy can cause spotting. Sex when your vagina isn’t lubricated enough, or with a very well endowed partner can cause small tears and therefore bleeding. Cervical bleeding can also occur during very deep penetration, or if your vaginal opening is small. Using an artificial lubricant and ensuring arousal before sex can prevent damage to the vagina during sexual activity. Inserting a tampon when you are too dry or too forcefully can also cause spotting.

9. Sexually Transmitted Infections (STIs)

STIs can cause vaginal bleeding. Chlamydia and gonorrhoea are the most common examples. As well as spotting between periods, bleeding during or after sex can occur. If left untreated, both chlamydia and gonorrhoea can cause serious health issues such as Pelvic Inflammatory Disease (see below) and even infertility. It’s always a good idea to get tested for STIs after unprotected sex with a new partner, especially as chlamydia does not often cause symptoms.

10. You Have Cervicitis

Cervicitis is inflammation or irritation of the cervix, most commonly caused by an STI. Whilst the symptoms, such as vaginal discharge, itching, pain with intercourse, and spotting, are very uncomfortable, cervicitis is easily diagnosed and treated by a GP.

11. You’re Suffering From Pelvic Inflammatory Disease (PID)

Pelvic Inflammatory Disease (PID) occurs when certain pelvic infections, caused by STIs or use of IUDs, go untreated. Aside from spotting, symptoms include pain in the lower abdomen, unusual vaginal discharge and pain during sex. PID is a serious condition that can affect a woman’s fertility, but when detected, can be easily treated with antibiotics. Find out more here .

12. You Have Recently Had an Abortion

Many people experience some bleeding after having a termination. Spotting may last for several weeks after having an in-clinic procedure or taking the abortion pill. If bleeding is very heavy, seek medical advice. for further information, visit the NHS website .

13. Pregnancy

Spotting or ‘implementation bleeding’ may occur in the early stages of pregnancy. It typically occurs 10 to 14 days after conception, when the fertilised egg attaches to the uterine lining, and before the mother’s period is due. Implementation bleeding is normal very early in pregnancy, but unlike menstrual blood, is usually a pink or brown coloured discharge. Bleeding in early pregnancy could also be a symptom of an ectopic pregnancy. This is a pregnancy that is growing somewhere other than the uterus, usually the fallopian tube. Ectopic pregnancy bleeding is often coupled with other symptoms including abdominal pain on one side, pelvic pain, shoulder pain, and/or dizziness. Seek immediate medical help if you experience symptoms of an ectopic pregnancy.

14. Loss of Pregnancy

Bleeding is one early sign of a miscarriage. In the unfortunate case of an impending miscarriage, the mother may experience abdominal cramping, back pain, lower abdominal pain and spotting. Miscarriages most commonly occur in the first 20 weeks of pregnancy.

15. Breastfeeding

In the postpartum phase, new mothers often experience spotting and irregular bleeding as opposed to their pre-pregnancy menstrual periods. Whilst breast-feeding suppresses ovulation, many women experience spotting during this time.

16. Ovarian Cysts

Spotting between periods can also be caused by ovarian cysts – small sacs filled with liquid that develop in your ovaries. In more extreme cases, ovarian cysts can rupture, causing lower pelvic pain, spotting, and severe discomfort. Normally, doctors will wait and see if the cysts resolve themselves. If they don’t, they can be surgically removed. Women with polycystic ovary syndrome (PCOS) have a hormonal imbalance that interferes with normal ovulation and therefore causes irregular periods and spotting. Other side effects include unwanted body hair, acne and weight gain. The most common treatment for PCOS is birth control or hormonal therapy.

17. The Menopause

Menopause is a natural part of the female ageing process, as a woman’s oestrogen levels drop to levels which mean that the ovaries no longer produce eggs. This usually happens between the ages of 45 and 55, and is marked by an end to periods and natural fertility. According to the NHS, the average age for a woman in the UK to reach the menopause is 51. During the transitional phase leading up to this, known as perimenopause, unstable hormone levels can cause irregular periods, spotting, and heavy bleeding. Once you enter menopause, all menstrual bleeding should stop.

If you are still bleeding into this stage however, consult your doctor immediately. Hormone replacement therapy (HRT), commonly used to relieve some of the symptoms of menopause, can also cause spotting. Women who are in menopause commonly experience vaginal dryness (or vaginal atrophy), as their ovaries are producing less oestrogen, causing a reduction in the number of lubricating glands. This can cause the vagina to feel itchy, dry and irritated. Using an artificial lubricant can help to prevent spotting caused by a tear to dry skin of the vagina.

18. You Have Adenomyosis

Adenomyosis occurs when tissue from the womb lining becomes embedded in the wall of the womb. The endometrial tissue thickens, breaks down, and bleeds, like it should in a normal menstrual cycle. However, an enlarged uterus can be painful and is one cause of heavy periods.

19. You Have Fibroids

Fibroids (also known as leiomyomas or myomas), are the abnormal growth of muscle tissue on your uterus, and can be to blame for spotting between periods. They range in size from tiny growths that are almost undetectable to the human eye, to large, bulky growths that can alter and enlarge your uterus. It is common for women to have uterine fibroids at some point in their life, and whilst often they present no symptoms, some women can experience heavy menstrual bleeding, spotting between periods, pelvic pressure or pain, frequent urination, and constipation.

20. You’ve Got Uterine or Cervical Polyps

Uterine Polyps, or Endometrial Polyps, are noncancerous growths which form when there is overgrowth of cells in the lining of the uterus. While polyps usually stay in the uterus, some can travel through the opening of the uterus (cervix) into the vagina. These are mainly found in women who are going through or have finished menopause. As well as unexpected bleeding, they may also cause irregular discharge, Polyps are often discovered during a smear test, and the majority of them are benign – but in rare cases, can be cancerous.

21. Cancer

In rare cases, spotting may be a symptom of cancers related to the reproductive system – vaginal, cervical, uterine, ovarian. Endometrial cancer is the most common of the gynaecological malignancies, and the most curable. It arises from the glandular tissue within the uterine lining. Ovarian cancer is a growth of abnormal malignant cells that begins in the ovaries. Symptoms include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, abnormal spotting, or urinary symptoms. Cervical cancer is detected through pap smears screenings and pelvic examinations. Vaginal spotting is the first type of symptom of the disease. Heavier vaginal bleeding, heavy vaginal discharge, and lower abdominal pain are other symptoms that occur. Early detection of these cancers is key. It is extremely important to get regular cervical screening test ,and talk openly to medical professionals about any symptoms you may be experiencing.

See Also:  Can You Get Tonsillitis Without Tonsils

Conclusion

The most common reasons for vaginal bleeding between periods are hormonal contraceptives or changes relating to menopause. If bleeding between periods is very heavy or lasts for longer than 3 months, seek medical advice. Regular cervical screening is an essential part of preventive healthcare, especially for women between ages 25 and 65. Keeping a menstrual diary and recording changes to your flow or length of bleeding will make the diagnosis and prevention of abnormal bleeding much easier.

When to call a doctor

If you’re concerned about your bleeding, you should:

  • See your GP
  • Visit a sexual health or genitourinary medicine (GUM) clinic

If you experience prolonged spotting or new and unexplained spotting book an appointment with your GP. Contact a doctor immediately if:

  • You have recently experienced rape.
  • You believe the spotting could be due to an injury.
  • You are pregnant or could be pregnant.
  • The spotting occurs after menopause.
  • If it develops into heavy menstrual-like bleeding.
  • If in addition to the spotting, you feel pain, exhausted or dizzy.

Disclaimer: Information on this site is provided as an informative resource only, and is not to be used or relied on for diagnostic or treatment purposes.

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What is spotting? Common causes and how to track it

How does spotting differ from other types of bleeding during your cycle?

Updated: Jul 10, 2024
Published: Jan 8, 2018
— Updated: Jul 10, 2024 | Published: Jan 8, 2018
Medically reviewed by Hannah Reiser, OBGYN, and Bridgette Holmes, CNM

Top things to know:

  • Spotting is any bloody vaginal discharge that doesn’t require the use of period products, like a pad or tampon (1).
  • Any unexplained spotting should be addressed with your healthcare provider (2).
  • Spotting can be a side effect of your hormonal contraceptive (3,4).
  • If you’re pregnant and spotting or bleeding, you should contact your healthcare provider (5).

What is spotting?

Researchers and healthcare providers define spotting as any bloody vaginal discharge that is not of a large enough volume to require sanitary protection (i.e. you don’t need to use a pad or a tampon) (1).

However, this definition can be confusing. Some people may choose to use panty liners when spotting. However, if you soak a panty liner, or need to use a pad or a tampon, then that likely isn’t spotting (1). In theory, spotting can happen at any time during your cycle, so around your period or between periods.

There are many different reasons why you could be spotting, from hormonal birth control to PCOS. It is thought that spotting a few days before your period starts, in the late luteal phase, may indicate higher levels of a form of progesterone, but more research is needed (6). Read on to find out what your spotting could mean.

Download Clue to track your feelings everyday

How does spotting differ from light period bleeding?

You can differentiate spotting from menstrual bleeding by examining the amount of blood (1). Spotting refers to a very small amount of bloody vaginal discharge that you may see as a few drops of blood on your underwear or toilet paper (7).

Light bleeding, on the other hand, is a slightly heavier form of bleeding than spotting. You may need to use menstrual products, like a tampon, pad, or a higher absorbency panty liner (8).

Generally, if you have light bleeding at the beginning of your period, you can consider that part of your period, not spotting (9). However, if it’s very, very lightyou only see a little on your toilet paperthat would be considered spotting (7).

For example, if you have spotting on Sunday, no bleeding on Monday, and bleed enough to require a tampon on Tuesday, you should consider Tuesday the start of your period.

Tracking tip: What if you initially logged spotting in the morning and then it turns into your period in the afternoon? No problem, you can always go back and change what you tracked in the Clue app. It’s important that the first day of your period is recorded correctly in order to provide more accurate predictions for your next cycle.

What is the difference between your period, spotting, and intermenstrual bleeding?

Menstrual bleeding is associated with the shedding of the endometrium at the beginning of the menstrual cycle (10). It typically occurs every 24–38 days and lasts up to eight days (11).

Spontaneous bleeding (typically lighter than a regular period) that happens between regular menstrual periods is called intermenstrual bleeding (9). If you experience intermenstrual bleeding, you should speak to your healthcare provider as this may be a sign of an underlying condition (12).

You can track intermenstrual bleeding with a custom tag in Clue. To create a custom tag, go to ‘Track’ and select ‘Tags’. Get Clue Plus to track an unlimited number of custom tags.

How can I track bleeding in the Clue app

If you track period bleeding and it’s been more than 10 days since you last tracked your period, that day will be counted as the first day of a new menstrual cycle.

When tracking your period in Clue, there are four tracking options: light, medium, heavy, and super heavy.

In Clue, there are two tracking options for spotting: red and brown.

Blood changes depending on how long it has been exposed to air, due to a process called oxidation (if you cut your finger you’ll notice the blood is bright red, but then it looks brown on the band-aid later—that same process can happen to menstrual blood as it moves out of your body) (13). Fresh blood often appears red, or pink if it’s mixed with other bodily fluids, while older blood tends to look brown, like uterine bleeding, which is commonly red or brown (14).

Clue users are more likely to track red spotting than brown spotting; around 3 out of 10 users track brown spotting, and around 4 out of 10 users track red spotting.

What are the common causes of spotting

Spotting can come from your upper reproductive tract (like your uterus) or your lower reproductive tract (like your vagina) (14,15), and can be cause by many different reasons:

Hormonal birth control

Spotting is a common side effect of hormonal contraception, especially during the first few months of starting a new method (16).

When you first start taking combined oral contraceptives, or birth control pills, you may experience spotting or breakthrough bleeding that goes away with time (16,17). Bleeding or spotting outside of your usual withdrawal bleed time can sometimes happen even if you take your birth control pills continuously (17).

Hormonal patches are effective as a contraceptive method but may cause spotting in between your regular withdrawal bleed (18). The longer you’re on the patch, the fewer spotting days you may have (18). Some people may stop spotting altogether with time (19).

  • IUD, implant, injection, mini-pill

Spotting and unpredictable bleeding are possible with the hormonal IUD, the contraceptive implant, the contraceptive shot (injection), and the mini-pill (a progestin-only pill), but it typically improves over time (18,20,21).

Pregnancy

Spotting is a common symptom in early pregnancy (5). About 1 in 4 people experience spotting in the first trimester (5). Spotting is usually nothing to worry about—research has shown that pregnant people who experience spotting are not more likely to have a miscarriage than people who don’t experience spotting (22). However, heavy bleeding during pregnancy may be more of a concern (5). If you’re pregnant and bleeding, call your healthcare provider to check in so they know what’s going on.

While many sources call spotting in early pregnancy “implantation bleeding,” there isn’t strong evidence that it’s associated with an embryo’s implantation in the uterus. It may actually be related to hormonal changes, as the production of progesterone switches from the ovary to the forming placenta (7).

Bleeding accompanied by pain while pregnant may indicate a miscarriage (5). After an early pregnancy stops developing, the inner tissue of the uterus, along with any new tissue that has grown, usually sheds by itself via the vagina. By the time you notice the bleeding, the pregnancy has already ended and there is nothing you can do to “stop” the miscarriage (23). Light spotting, especially when it only lasts 1–2 days, is typically not associated with miscarriages (7,22).

Spotting can be a symptom of an ectopic pregnancy (24). This is a pregnancy that is growing somewhere other than the uterus, usually the fallopian tube (24). Ectopic pregnancy bleeding may be coupled with other symptoms including abdominal pain on one side, shoulder pain, and/or dizziness (24). If you experience symptoms of spotting and suspect you may have an ectopic pregnancy, seek immediate medical help (24).

Physical conditions and issues

Spotting can also be caused by infections and physical changes in the reproductive tract, or hormonal imbalances (15).

Uterine polyps are typically non-cancerous growths within your uterus (25). Spotting is one of the most common symptoms of uterine polyps (25). Other symptoms of polyps include abdominal pain and difficulty becoming pregnant (25). Typically, any abnormal bleeding related to polyps improves after treatment (25).

Sometimes, sexually transmitted infections (STIs) can cause spotting or bleeding (15). Most chlamydia infections have no symptoms, but some people may notice abnormal vaginal bleeding or discharge, pelvic pain, or painful urination (15). Similarly, gonorrhea can cause atypical vaginal bleeding and increased urination (15). Chlamydia and gonorrhea can both be treated with antibiotics from your healthcare provider (15).

Endometriosis affects about 1 in 10 women of reproductive age (26). You may have endometriosis if you experience persistent pelvic pain, exceptionally painful periods, or painful intercourse (endometriosis). Spotting is another consistent symptom (27). For people with endometriosis, spotting is more common 2–3 days before their period starts (27).

Pelvic inflammatory disease (PID) happens when certain pelvic infections (like STIs) spread upwards from the lower reproductive area (28). It can also be another cause of unscheduled bleeding (28). Other symptoms of PID can include pain in the lower abdomen, increased vaginal discharge, and fever (15). If you suspect you have spotting and other associated symptoms of PID or physical pelvic conditions, discuss this with a healthcare professional as soon as possible (28).

Urinary tract infections (UTIs) can cause bleeding when you urinate (29). Urinary tract infections can be caused by infections somewhere in the urinary tract (29). Pain while urinating, paired with a small amount of blood on the toilet paper, might be signs of a UTI (29). Your healthcare provider can offer treatment for UTIs.

How I deal with my UTIs

After experiencing multiple UTIs, I’ve figured out UTI remedies that work best.

Fibroids are non-cancerous tumors within the uterus (30). They can cause changes to your bleeding pattern, including heavy menstruation and intermenstrual bleeding (30). Other symptoms of fibroids include abdominal pain and difficulty becoming pregnant (30). Your healthcare provider may be able to recommend a treatment option to manage your unexpected bleeding and uterine fibroids (30).

Bleeding after penetrative vaginal intercourse is not considered typical (31). Bleeding regularly after sex (postcoital bleeding) may be caused by an issue with the cervix, infection, or polyps (31). If you’re noticing spotting after sex, talk to your healthcare provider (31).

Sometimes, trauma to the vagina can cause bleeding (31). This could be because of an abortion or pelvic exam, (32), after experiencing sexual assault (31), or when a foreign object is used to penetrate the vagina (33).

Vaginal bleeding is a common symptom for people with endometrial cancer (34). With endometrial cancer, you may experience abdominal pains and changes to your bowel movements (35). If you notice bleeding when you urinate, it may rarely indicate bladder cancer (34). Report these symptoms to your doctor so that they can create an individualized treatment plan to manage your symptoms (34).

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Ovulation

More research needs to be done to support the association between spotting and ovulation. Spotting can occur around the time of ovulation, however, it’s unclear why some people experience ovulation bleeding while others don’t—some research suggests it happens in people who have hormone levels that are higher (35).

Hormonal conditions and changes

In some instances, spotting can be a sign of a hormonal condition or change in your reproductive life stage. For example, very light and infrequent bleeding while not on hormonal birth control can be a sign of an ovulatory disorder (36).

Polycystic ovary syndrome (PCOS) is a common disorder for people with cycles that causes atypical bleeding patterns. You may notice intermenstrual bleeding, irregular periods, or infrequent menstruation (11). Menstrual changes and infertility are the most common complaints for people with PCOS (36). Other symptoms include increased body hair, weight gain, and diabetes (36).

People with hyperthyroidism, an overactive thyroid, or hypothyroidism, an underactive thyroid, can experience profound changes to their reproductive system (37). If you have hypothyroidism, you may experience heavy or long periods, frequent menstruation, weight gain, or hair loss (37, 38). If you have hyperthyroidism, you may notice heavier periods or weight loss (37,38).

During perimenopause, your body is beginning to make the transition to menopause. On average, perimenopause begins in your 40s and can take about 4 to 8 years (39). While you’re going through perimenopause, you may notice changes to your normal bleeding pattern and your cycles may become longer or shorter (39). Vaginal dryness, difficulty falling asleep, and mood changes are additional symptoms of perimenopause (39).

Download Clue to use Clue Perimenopause mode.

The importance of tracking your spotting

You can use the Clue app to track your spotting. Tracking is important because it can help you determine the cause of spotting and if you should see a doctor.

Monitor how frequently you are spotting and see if it correlates with any other symptoms or activities (40). You can use data from the Clue app during your next appointment with your healthcare provider to advocate for yourself and feel confident in your menstrual experiences.

When to contact a doctor

Visit your doctor immediately if you notice any of the following symptoms alongside your bleeding or spotting:

  • Abdominal pain that is not typical for you (43)
  • Dizziness or fainting (43)
  • Painful defecation (43)
  • Weight changes (38)
  • Fatigue (38)

These symptoms may indicate an underlying condition that warrants medical intervention (43,38).

Now you know more about what spotting could mean

There are several different reasons you could be spotting. In some cases, spotting can indicate an underlying condition that warrants treatment. Sometimes, it may go away on its own (16).

The Clue app can help you track your spotting so that you can see it’s not in your head, it’s in your data. Data can empower you to learn more about your cycle and personal patterns. You can use this information at your next doctor’s appointment (40).

FAQ

  • Should I take a pregnancy test if I am spotting?

Spotting is a common symptom of early pregnancy (5), however, if you are spotting, this does not necessarily mean you are pregnant. There are several other reasons why you could be spotting (19,15). But if you had unprotected sex and you experience any of the following symptoms along with spotting, you should consider taking a test:

  • Nausea or vomiting (41)
  • Pelvic pain (41)
  • Back pain (41)
  • Weight gain (42)
  • Vaginal discharge (42)
  • Why am I spotting but have no period?

People with PCOS may have no periods, or their periods may be very unpredictable (11). Certain contraceptives, like the shot, can also cause spotting and halt periods (20). Lifestyle factors such as stress can also affect the heaviness and regularity of your bleeding.

Spotting can be caused by many things, from hormonal birth control (16) to thyroid conditions (37), cancer (34), endometriosis (27), perimenopause (39), or pregnancy (5). There are several different reasons for irregular bleeding. Your healthcare provider can help you determine the reason behind your spotting.

This article was originally published on October 5, 2017.

Download Clue today to track spotting and your period to discover your personal patterns.

References

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  3. Maldonado LY, Sergison JE, Gao X, Hubacher D. Menstrual bleeding and spotting with the Levonorgestrel Intrauterine System (52 mg) during the first-year after insertion: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology [Internet]. 2020 [cited 2024 Jun 26];222(5):451-468.e9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002937819312104
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  5. Hendriks E, MacNaughton H, MacKenzie MC. First Trimester Bleeding: Evaluation and Management. Am Fam Physician. 2019 Feb 1;99(3):166–74.
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  11. Munro MG, Balen AH, Cho S, Critchley HOD, Díaz I, Ferriani R, et al. The FIGO Ovulatory Disorders Classification System. Human Reproduction [Internet]. 2022 Sep 30 [cited 2024 Jun 26];37(10):2446–64. Available from: https://academic.oup.com/humrep/article/37/10/2446/6670602
  12. Achanna KS, Nanda J. Evaluation and management of abnormal uterine bleeding. Med J Malaysia. 2022 May;77(3):374–83.
  13. Mustafa I, Hadwan TAQ. Hemoglobin Oxidation in Stored Blood Accelerates Hemolysis and Oxidative Injury to Red Blood Cells. J Lab Physicians [Internet]. 2020 [cited 2024 Jun 26];12(04):244–9. Available from: https://jlabphy.org/hemoglobin-oxidation-in-stored-blood-accelerates-hemolysis-and-oxidative-injury-to-red-blood-cells/
  14. Murji A, Sanders AP, Monteiro I, Haiderbhai S, Matelski J, Walsh C, et al. Cesarean scar defects and abnormal uterine bleeding: a systematic review and meta-analysis. Fertility and Sterility [Internet]. 2022 [cited 2024 Jun 26];118(4):758–66. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0015028222004137
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  16. Gemzell‐Danielsson K, Apter D, Zatik J, Weyers S, Piltonen T, Suturina L, et al. Estetrol‐Drospirenone combination oral contraceptive: a clinical study of contraceptive efficacy, bleeding pattern and safety in Europe and Russia. BJOG [Internet]. 2022 [cited 2024 Jun 26];129(1):63–71. Available from: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16840
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Dr Narelle Bleasel FACD
Dr Narelle Bleasel FACD

Dermatologist in Battery Point, Australia

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