Bleeding or spotting in between periods CAN mean cancer but also many other benign causes, and missed menstruation has a ton of causes.

Have you ever spotted in between periods? Seen blood stains on your underwear or on the tissue paper after you wiped yourself?

What’s the first thing that came to your mind?

Or, if this has not happened to you, what do you THINK would be the first thought that occurred to you? “Could I have cancer?”

Well, the truth is, bleeding in between doesn’t always mean cancer. On the other hand, it’s a very common symptom of uterine (endometrial) cancer.

It can be a sign of ovarian cancer, but only rarely.

Another cause, believe it or not, can be sitting on a hard bicycle seat and pedaling furiously — with no cycling exercise history, or after a long absence from cycling.

The jarring and pressure against a hard seat can cause mild spotting, but this does not come from the genital area; it’s likely from microscopic tears in the anal area.

This actually happened to me after pedaling furiously on a stationary bike—so hard, in fact, that when I was done, the bike had moved across the floor.

Another cause is doing rigorous jumping drills — again, with no jumping history, or after a long absence from jumping routines.

This has happened to me. But the spotting in these cases is either immediately after the exercise, or a little later on, and does not persist; it’s usually a one-time occurrence shortly after the activity.

If you haven’t done these activities and are bleeding (or spotting) in between periods, take this cue seriously, especially if you are postmenopausal.

It can mean cancer, though it can also have many other, less serious causes (which is actually usually the case).

Postmenopausal vaginal bleeding is a symptom of cancer in about 30 percent of cases.

About 90 percent of women with uterine cancer experience vaginal spotting or bleeding in between periods, or after menopause, according to the American Cancer Society.

Vaginal bleeding is often the first clue that something is wrong.

Other symptoms may not show until the disease is advanced.

Other symptoms of uterine cancer: prolonged periods; a pink, watery or white vaginal discharge (note: a milky-white discharge is also normal; this is known as “between-period discharge”).

It’s best to frequently monitor yourself so that you become familiar with what is normal and routine for your body, and what suddenly becomes different.

This could include pain during intercourse; a pelvic mass; pelvic pain; and unexplained weight loss (these usually occur in later disease stages).

Known Risk Factors for Uterine Cancer

• Diabetes

• Advanced age

• Longer menstrual span (i.e., time span from menstrual onset in adolescence to menopause)

• Never having been pregnant

• Obesity

• Higher lifetime-exposure to estrogen

• Pelvic radiation therapy

• Family history

• Breast/ovarian/colorectal cancer personal history.

Bleeding in Between Periods: Summary

The patient’s age factors into most probably causes, says Justin Chura, MD, a gynecological oncologist with Crozer Health in Delaware.

“For example, in a 20-year-old woman on birth control pills, bleeding between periods is very common, and the risk of cancer is extremely low.

“On the other hand, for a woman in her early 50s who still has menstrual periods and is now experiencing bleeding in between periods, further evaluation is needed including an ultrasound and possibly a biopsy.”

By the way, eating beets or juiced beets can cause urine to have a reddish tinge (from the beets’ red pigment), and this might pass for “bleeding in between periods.”

Missed period but not pregnant or menopausal?

Relax, it’s not a sign of cancer. Other causes of a missed period include:

– Severe dieting/substantial weight loss in short period of time

– Excessive, rigorous exercise, particularly related to endurance training

– Unusual amounts of stress

– Fast weight gain, or obesity

– Bulimia (vomiting food to lose weight)

– Birth control pills

– Depo-Provera injections

– Hormone imbalance

– Polycystic ovarian disease (hormone imbalance interferes with normal ovulation)

– Breast feeding

– Travel

– Illegal drug use

– No known cause – missed periods (in absence of pregnancy) are not that uncommon, and may actually mean nothing is up at all.

Nevertheless, it would be wise to see a gynecologist if you have missed two periods in a row, or two periods in 12 months.

Dr. Chura provides standard cancer care and robotic surgery for cancers of the cervix, ovary, uterus/endometrium and vulva.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: Shutterstock/siam.pukkato