Bleeding that occurs outside the normal menstrual cycle can be concerning for many women. This condition is known as metrorrhagia, which refers to vaginal bleeding that occurs between menstrual periods. The amount of bleeding can vary, ranging from light spotting to heavier bleeding, and it can affect women of different ages.
Metrorrhagia is not a disease itself but rather a symptom that may be caused by various underlying medical conditions. Common causes include hormonal imbalances, uterine fibroids, reproductive tract infections, pregnancy complications, and more serious conditions such as cancer. Understanding the cause of bleeding between periods is important to ensure appropriate diagnosis and treatment.
Contents
Causes of Bleeding Between Periods That Should Not Be Ignored
Below are some of the most common causes of bleeding outside the menstrual cycle:
1. Hormonal Imbalance
Estrogen and progesterone are the two primary hormones responsible for regulating the menstrual cycle. When these hormones become imbalanced, abnormal bleeding or spotting between periods may occur. Several factors can affect hormonal balance, including:
- Ovarian dysfunction
- Thyroid disorders
- Starting or stopping birth control pills
Some women may also experience spotting during ovulation due to natural hormonal fluctuations.
Irregular bleeding is also relatively common during the first three months of using hormonal contraception. Types of contraceptives associated with this condition include:
- Birth control pills
- Intrauterine devices (IUDs)
- Contraceptive patches
- Contraceptive implants or injections
2. Pregnancy Complications
Certain pregnancy-related complications can lead to vaginal bleeding or spotting. Two of the most common causes are miscarriage and ectopic pregnancy.
An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, most commonly in the fallopian tube. This condition requires immediate medical attention because it can pose serious health risks to the mother.
Although spotting during pregnancy does not always indicate a miscarriage, any vaginal bleeding during pregnancy should be evaluated by a doctor to determine the underlying cause.
3. Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop within or on the wall of the uterus. They are relatively common among women of reproductive age, particularly those who have given birth.
One of the most common symptoms of uterine fibroids is heavy menstrual bleeding or bleeding that occurs outside the normal menstrual cycle. Treatment options depend on the size, number, location of the fibroids, and the symptoms experienced by the patient.
At Mandaya Royal Hospital Puri, uterine fibroids can be treated without surgery using High-Intensity Focused Ultrasound (HIFU) technology. HIFU is a non-surgical treatment that uses high-intensity ultrasound waves to shrink fibroids without requiring incisions or surgery.
This technology works by delivering focused thermal energy directly to the fibroid tissue, causing controlled destruction of fibroid cells. Over time, the fibroid gradually shrinks while surrounding healthy tissue remains unharmed.
The HIFU procedure is performed under real-time imaging guidance, allowing physicians to clearly identify the fibroid and precisely target the treatment area.
Some of the advantages of HIFU for uterine fibroid treatment include:
- No incisions, stitches, or surgical wounds
- Short recovery period, with most patients returning to normal activities within 1–2 days
- Minimal discomfort because the procedure is performed under light anesthesia
- High precision due to focused ultrasound energy directed at the fibroid
- Lower risk of complications such as infection, bleeding, or adhesions compared to surgery
- A suitable option for women who wish to preserve their uterus and maintain future fertility
4. Infection
Bleeding between menstrual periods may also be a sign of an infection affecting the female reproductive organs. Infections can cause inflammation, which may result in abnormal bleeding.
Potential causes include:
- Sexually transmitted infections (STIs)
- The use of vaginal douches or certain vaginal cleansing products
- Sexual intercourse that causes irritation or infection
- Pelvic inflammatory disease (PID), an infection of the reproductive organs that may lead to scarring
5. Cancer
In less common cases, bleeding between periods may be caused by cancers of the female reproductive system, including:
- Cervical cancer
- Vaginal cancer
- Uterine cancer
- Ovarian cancer
For this reason, recurrent bleeding, prolonged bleeding, or bleeding accompanied by other symptoms should be evaluated promptly to identify the cause as early as possible.
Other Less Common Causes
In addition to the conditions mentioned above, abnormal vaginal bleeding may occasionally be caused by:
- A foreign object inside the vagina
- Severe or prolonged stress
- Diabetes
- Thyroid disorders
- Significant weight gain or weight loss
When Should You See a Doctor?
You should consult a doctor if you experience abnormal vaginal bleeding, especially if it occurs repeatedly or without a clear cause. Medical evaluation is necessary to determine the underlying condition and provide appropriate treatment.
If you are pregnant and experience vaginal bleeding, seek medical attention immediately.
You should also seek urgent medical care if bleeding is accompanied by any of the following symptoms:
- Severe pain
- Excessive fatigue
- Dizziness or fainting
- Fever.
OB-GYN Specialists at Mandaya Royal Hospital Puri
To determine the underlying cause of abnormal bleeding and receive appropriate treatment, you may consult one of the obstetrics and gynecology (OB-GYN) specialists at Mandaya Royal Hospital Puri. Below are some of the doctors available for consultation:
1. dr. Doddy F.P. Gultom, Sp.OG(K), M.Kes
dr. Doddy F.P. Gultom, Sp.OG(K), M.Kes is a consultant obstetrician and gynecologist with extensive experience in managing various women’s reproductive health conditions, including abnormal uterine bleeding, uterine fibroids, and other gynecological disorders. He completed his medical degree at Trisakti University, his OB-GYN specialist training at Hasanuddin University, and his consultant training at the University of Indonesia.
His clinical services include the diagnosis and treatment of gynecological conditions, reproductive imaging, management of pregnancy complications, and various minimally invasive procedures tailored to each patient’s needs.
Practice Schedule:
- Tuesday: 5:00 PM – 8:00 PM
- Thursday: 1:00 PM – 4:00 PM
- Saturday: 8:00 AM – 12:00 PM
2. dr. Edward Tony Ngantung, Sp.OG
dr. Edward Tony Ngantung, Sp.OG is an obstetrician and gynecologist who manages a wide range of women’s health conditions, including bleeding between periods, uterine fibroids, and other gynecological disorders. He graduated from Sam Ratulangi University and San Juan de Dios Educational Foundation and completed his OB-GYN adaptation program at Udayana University.
In addition to providing comprehensive women’s reproductive healthcare, he is experienced in performing minimally invasive procedures for various gynecological conditions.
Practice Schedule:
- Monday: 2:00 PM – 4:30 PM
- Tuesday: 11:00 AM – 2:00 PM
- Wednesday: 5:00 PM – 8:00 PM
- Thursday: 5:00 PM – 8:00 PM
- Friday: 10:00 AM – 2:00 PM
- Saturday: 9:00 AM – 1:00 PM
3. dr. Erik Sutandi, Sp.OG
dr. Erik Sutandi, Sp.OG is an obstetrician and gynecologist who treats various reproductive health conditions, including uterine fibroids and abnormal menstrual bleeding. He completed his medical education at Maranatha Christian University and his specialist training at San Juan De Dios Hospital, Manila.
In addition to pregnancy and childbirth services, he provides gynecological examinations, transvaginal ultrasound, fertility evaluations, and treatment for a variety of reproductive health concerns.
Practice Schedule:
- Monday: 5:00 PM – 8:00 PM
- Wednesday: 2:00 PM – 4:00 PM
- Friday: 5:00 PM – 8:00 PM
- Saturday: 2:00 PM – 4:00 PM
4. dr. Gracia Merryane R.G. Rauw, Sp.OG
dr. Gracia Merryane R.G. Rauw, Sp.OG is an obstetrician and gynecologist specializing in women’s reproductive health and the management of gynecological conditions, including uterine fibroids, uterine polyps, and abnormal uterine bleeding. She completed both her medical and specialist training at the Faculty of Medicine, Sam Ratulangi University.
Her services also include a variety of gynecological procedures such as laparoscopy, hysterectomy, Pap smear examinations, and other treatments tailored to the patient’s condition.
Practice Schedule:
- Monday–Saturday:
- 8:00 AM – 11:00 AM
- 1:00 PM – 6:00 PM
5. dr. Rahmadsyah, Sp.OG(K)FER, M.Kes, MARS
dr. Rahmadsyah, Sp.OG(K)FER, M.Kes, MARS is a fertility consultant obstetrician and gynecologist who also treats a variety of reproductive disorders, including hormonal abnormalities that may contribute to irregular menstrual bleeding.
He earned his medical degree from Padjadjaran University and completed his specialist and Master of Health programs at Hasanuddin University. His services include hormonal evaluations, fertility assessments, transvaginal ultrasound examinations, reproductive consultations, and various gynecological treatments based on patient needs.
Practice Schedule:
- Monday–Saturday: 1:00 PM – 4:00 PM
6. dr. Sigit Pradono Diptoadi, Sp.OG
dr. Sigit Pradono Diptoadi, Sp.OG is an obstetrician and gynecologist experienced in treating a variety of women’s reproductive health issues, including uterine fibroids, menstrual disorders, and bleeding between periods. He earned his medical degree from Atma Jaya Catholic University of Indonesia and completed his specialist training at Ramon Magsaysay Memorial Medical Center, University of the East.
His expertise includes gynecological consultations, ultrasound examinations, fertility programs, and management of various reproductive health concerns.
Practice Schedule:
- Monday: 5:00 PM – 8:00 PM
- Friday: 5:00 PM – 8:00 PM
- Saturday: 5:00 PM – 8:00 PM
7. Dr. dr. Unedo Hence Markus Sihombing, Sp.OG, Subsp. Onk
Dr. dr. Unedo Hence Markus Sihombing, Sp.OG, Subsp. Onk is a gynecologic oncology specialist who manages a wide range of conditions affecting the female reproductive system. These include disorders that may cause abnormal bleeding, such as uterine polyps, uterine tumors, cervical cancer, uterine cancer, ovarian cancer, vulvar cancer, and vaginal cancer.
He completed his education at Sriwijaya University, Sebelas Maret University, and the University of Indonesia, where he obtained both his consultant and doctoral qualifications. His extensive experience in managing complex gynecological cases makes him a valuable specialist for patients whose abnormal bleeding may be associated with tumors or gynecologic cancers.
Practice Schedule:
- Tuesday: 4:00 PM – 8:00 PM
- Thursday: 4:00 PM – 8:00 PM
- Saturday: 1:00 PM – 4:00 PM
To make your visit to Mandaya Royal Hospital Puri more convenient, you can use the WhatsApp Chat feature, Book Appointment service, or the Care Dokter application available on Google Play and the App Store. These services allow you to schedule appointments, view queue numbers, and access other useful information.
The information provided on this page is intended for educational and general informational purposes only and does not represent the full range of medical services offered by each physician. To ensure appropriate care based on your specific condition, it is recommended that you consult directly with the relevant doctor.
If you have any questions, suggestions, or require further information, please contact our call center at 0811-1900-2000.
