Bleeding outside the rule

Bleeding outside the rule

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Between bleeding and spotting

Bleeding outside of the normal period is also called spotting or spotting. These are bleeding events that occur outside of the monthly female cycle. Such bleeding, known as metrorrhagia, is not necessarily a cause for concern. Intermediate bleeding can occur as a result of unusual stress or due to a change in climate. In general, bleeding outside the rule should be clarified by a gynecologist. Intermediate bleeding is similar in blood color to a menstrual period, whereas spotting is more brownish.


The most diverse causes are possible for bleeding outside the rule. A medical examination with a detailed medical history, laboratory examinations and an ultrasound examination can determine the exact cause in most cases.


Not every woman feels that ovulation is the same. One does not notice him at all and the other complains of so-called middle pain, possibly together with an ovulation bleeding. This is harmless, but can also be treated with the help of naturopathy.

Implantation bleeding

An implantation bleeding (nidation bleeding) also belongs to the bleeding outside the rule. This can, but does not have to take place, about five to seven days after implantation of the fertilized egg (beginning of pregnancy). This is due to small blood vessels that can bleed a little. This bleeding outside the rule is easy, i.e. weaker than the menstrual bleeding. It resembles spotting and is usually dark red to brownish. The duration is different. It lasts about one to three days and can be accompanied by pain.


Bleeding outside the rule, which occurs during pregnancy, does not necessarily have to be threatening, but should definitely be clarified immediately.

The pill"

Undesirable intermenstrual bleeding may occur while taking the pill. For example, if the pill was started again or the preparation was changed. This can also happen with irregular intake. In addition, the intermenstrual bleeding can indicate that the prescribed pill does not fit the woman and that another preparation may have to be taken.

Hormone disorders

Hormone disorders can lead to bleeding outside the normal range. A spotting that occurs two to three days before the desired menstrual period indicates a yellow body deficiency. A spotting after menstruation suggests a lack of estradiol (the most important of the three "estrogens": estradiol, estrone, estriol). In the menopause, the woman gets into a "mess of hormones". This can also lead to spotting or spotting. Bleeding or spotting is also possible during puberty, until the girls' cycle has really settled in.

Contact bleeding

Bleeding outside the normal period can occur as contact bleeding. These are bleeding after sexual intercourse or in connection with a gynecological examination or by wearing a spiral. The mucous membrane that is close to the cervix bleeds. This is very thin and the vessels that supply the mucous membrane are very close to the surface. Contact bleeding mostly affects young women. Often this symptom goes away on its own, without any treatment. However, the contact bleeding should definitely be clarified gynecologically.

Thyroid disorders

Existing hypothyroidism can, but does not have to, lead to cycle disorders, such as bleeding outside the normal period. Both the thyroid and the ovaries are regulated by the same control centers (hypothalamus and pituitary). Example: The autoimmune disease of the thyroid gland, Hashimoto's thyroiditis, which causes hypothyroidism in the course of the disease, affects the whole body and also the sex hormones. If these are not in balance, intermediate or spotting may occur.

Even with an overactive thyroid gland, which is accompanied by weight loss, increased thirst, restlessness, sensitivity to heat and palpitations, menstrual cycle disorders in the form of bleeding can occur outside of the rule, up to the absence of the period (amenorrhea).


Diabetes is a metabolic disorder that affects the entire organism and can also negatively affect a woman's normal cycle.

Liver dysfunction

Liver dysfunction also affects the entire metabolism, but also affects the release of hormones. This can lead to irregular bleeding or even complete absence of the rule.


Bleeding outside the rule can occur in connection with inflammation of the cervix. The sufferers suffer from yellowish discharge. If pain and fever are added, this can indicate inflammation of the uterus. The causes for this are, for example, chlamydia, gonococci and streptococci, which cut their way from the vagina to the uterus.

Tumors, polyps, fibroids

Polyps or fibroids in the uterus can cause bleeding outside the rule. A fibroid is a benign growth in the muscle layer of the uterus. A polyp in the uterus is a benign tumor consisting of endometrial cells.

Cancer can also cause bleeding outside the rule, especially if the period is long past, so the woman is already beyond the menopause. Such sudden bleeding must be examined as soon as possible.

Examination and therapy

Bleeding outside the rule that occurs once, such as due to psychological stress or climate change, is not necessarily a cause for concern. However, if bleeding occurs more frequently, this should be clarified urgently by a gynecologist. Bleeding after the menopause should always be a reason for a specialist examination.

The gynecologist will examine the affected woman closely after a detailed medical history. Laboratory examinations and an MRI or CT may be necessary. Underlying diseases that trigger the bleeding are treated with the appropriate means.

Naturopathic treatment

In the event of bleeding outside the rule, a visit to the doctor is necessary before naturopathic treatment can be given to a naturopath. Serious illnesses must be excluded.

If the cause of the bleeding is a hormonal imbalance, the therapist can order a saliva hormone test in which the various hormones such as progesterone and estradiol are tested. Based on the findings, bio-identical hormones or plants from phytotherapy are prescribed. For example, the lady's mantle has a hormonally balancing effect. Chaste tree is used to strike a balance between estrogen and progesterone. The silver candle, hops and fenugreek have a very gentle estrogen-like effect.

Hormonal disorders are also often treated with acupuncture in naturopathy. Reflexology therapy is also a good way to balance the hormonal situation. For your part, thyroid disorders must of course be clarified by a doctor. However, naturopathic therapy can also serve well with conventional medicine. Inflammation can also be treated well with phytotherapy, homeopathy and with Schüßler salts.

Liver dysfunction naturally belongs in medical hands. However, milk thistle for the liver, for example, can do a lot of good. This plant is prescribed in the form of tea, in capsules or in drops.

In case of contact bleeding, if gynecologically clarified beforehand, depending on the cause, plants such as lady's mantle, shepherd's purse, yarrow and tin herb help. The moderate pain, which often occurs in connection with bleeding, responds quite well to the following medicinal plants: lady's mantle for the cramp-like pain and bleeding, gooseberries for cramps, yarrow for pain and bleeding.

Final word

Bleeding outside the rule should always be taken seriously. They do not have to mean anything bad, but should be checked with a doctor, especially if they occur repeatedly. It's better to clarify too much than not enough! (sw)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Susanne Waschke, Barbara Schindewolf-Lensch


  • Rico Kuhnke, Stefan Braun; "Non-dangerous - or not? - Vaginal bleeding", in: save !, Volume 4 Issue 1, 2016, Thieme Connect
  • Meinert Breckwoldt et al .: Gynecology and Obstetrics, Thieme, 2007
  • Elisabeth P. Jagfeld, Barbara C. Heuschkel: Naturopathy: The book for practice, Books on Demand, 2014
  • Werner Rath, Jörg Baltzer: Diseases in Pregnancy: 177 tables, Thieme, 2005
  • Pschyrembel Online: (access: 05.09.2019), contact bleeding
  • Benno Clemens Runnebaum, Thomas Rabe: Gynecological Endocrinology and Reproductive Medicine, Springer, 1994
  • Elvira Bierbach: Naturopathic Practice Today: Textbook and Atlas, Urban & Fischer, 2013

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