Spotting between cycles

Dear Alice,

My wife freaks out whenever she has any sign (even a speck) of blood between periods. Often she has some blood around the time of ovulation and she believes it is from metilsmerz (sp?). Even so she has an inordinate fear of having cancer whenever she has bleeding or if her period is off by even a day. Is this normal? When should she really be concerned about cervical cancer? What would account for occasional spotting between cycles?

— Hubby

Dear Hubby,

Occasional spotting (bleeding between periods) is a normal issue for women of all ages. Your wife may be experiencing "mittleschmerz" (German for middle pain). During the ovarian cycle, with the help of hormones, about ten to twenty of the thousands of follicles within the ovary begin to mature. One of these follicles develops an egg that can be fertilized. Eventually, the follicle and ovarian surface open up to let the egg float out. Women respond differently to this phase of the cycle, called ovulation. Some women feel a slight pain or cramp, some release a vaginal discharge that can include blood, some get headaches, gastric pain, or feel lethargic, and some women feel nothing at all. The pain and/or discharge is called "mittleschmerz."

However, it is recommended that when a female experiences spotting between cycles, that she see a health care provider to make sure that her breakthrough bleeding is normal and not a symptom of another problem, including endometriosis, uterine fibroids, cervical cancer, ovarian cysts, or a lingering STI. Your wife's fears about developing cancer are not uncommon. Although cancer rates are low, media exploitation, false information, and horror stories about cancer treatment are enough to make a woman worry with any possible variation from her body's normal state. A complete examination and discussion with her health care provider should alleviate her fears and help her focus on staying healthy.

Only your wife’s health care provider can truly assess when she should be concerned about cervical cancer. If caught in its early stages, cervical cancer has a very high cure rate. Therefore, it is wise for your wife, and all women, follow the recommended guidelines for having pap smears and gynecological exams, so that any abnormal cells can be detected and treated as early as possible.

Last updated Jul 20, 2015
Originally published Oct 27, 1995

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