Definition: Intermenstrual bleeding (IMB) or metrorrhagia, is vaginal bleeding that occurs at irregular intervals between expected menstrual periods.

Normal vs. Abnormal: While some spotting can be normal, especially when starting or stopping hormonal birth control, persistent or heavy bleeding between periods warrants medical attention.

1. Hormonal Imbalances: Fluctuations in estrogen and progesterone levels can disrupt the menstrual cycle, leading to irregular bleeding.

2. Hormonal Contraception: Starting or stopping hormonal birth control methods (like the pill, patch, or IUD) can cause spotting.

3. Uterine Issues: Conditions like fibroids (noncancerous growths in the uterus), polyps (growths on the lining of the uterus or cervix), or endometriosis (where uterine tissue grows outside the uterus) can cause irregular bleeding.

4. Infections: Sexually transmitted infections (STIs) or infections of the cervix or uterus can lead to bleeding.

5. Other Conditions: Underlying health problems like thyroid issues, blood clotting disorders, or certain medications can also contribute to irregular bleeding.

6. Cancer: In rare cases, irregular bleeding can be a sign of cancer of the cervix, uterus, or fallopian tube.

1. If you experience bleeding between periods, especially if it's heavy, prolonged, or accompanied by other symptoms like pain or fever.

2. If you have any concerns about your menstrual cycle or bleeding patterns.

3. If you are sexually active and have not been diagnosed with a STI, it is important to get tested.

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