Whether it's tampon tax that you're campaigning against or you're celebrating one key player in the sanitary towel industry finally appreciating that our periods aren't (surprisingly enough) blue, it seems that periods are being discussed more openly than ever before. Whatever you call your period, apparently there are a staggering 5000 synonyms for menstruating (my absolute favourite so far is 'Granny's stuck in traffic' - what?!), individual experiences of having a period (timing, length, quantity, level of comfort or discomfort) vary greatly.
But what about when bleeding happens when you're not expecting it? I don't mean getting caught out without your 'emergency' sanitary towel or tampon in your desk drawer; I mean vaginal bleeding that isn't your usual period (or withdrawal bleed if you're using hormonal contraception).
Whilst commonly (and associated with heavy periods for about one third of women), paying a visit to your GP surgery or nearest sexual health clinic for further assessment is completely reasonable. So, let's talk terminology. There are three main terms to be aware of when describing vaginal bleeding and we'll go through each in turn. Causes vary with age and some women present with a combination of the different bleeding patterns.
• Intermenstrual bleeding - this is when you bleed in between normal periods. If you don't have regular cycles, this can be a difficult one to pick up
• Postcoital bleeding - bleeding immediately after sex
• Breakthrough bleeding - irregular bleeding associated with hormonal contraception (some people refer to this as 'spotting'). It is particularly reasonable to seek medical advice if this is worrying you or has lasted for longer than 3 months
If you have any of the above symptoms, there are three important questions to consider before, during and after seeing a doctor:
1. Is there any chance that you could be pregnant?
- If there's a possibility that you could be - take a pregnancy test!
- Bleeding is common in the early stages of pregnancy and it doesn't always mean that there's a problem
- However, bleeding can also be a warning sign of early complications of pregnancy or miscarriage
NB. If you know that you're pregnant (first trimester) and you experience pain and/or vaginal bleeding then you should seek medical advice
2. When was your last STI check?
- Sexually transmitted infections can pass from one person to another through unprotected sexual intercourse or genital contact
- They don't always cause symptoms but it's worth being tested regularly even if you feel fine, especially if you have recently changed sexual partners
- Remember, most infections can be treated (so locate your nearest sexual health clinic here)
3. Are you up to date with your cervical smear tests?
- If you're 25 to 49 years old, you'll receive a letter in the inviting you for cervical screening (a short procedure where a plastic brush is used to remove some cells from your cervix i.e. the neck of your womb).
- If you're over 50 years old, you'll be invited for screening every five years until you're 65
- If you're over 65, you are only screened if you haven't had a smear since the age of 50 or if you've had a recent abnormal smear test
When you attend a clinic, a qualified healthcare professional will ask you some questions about your symptoms and may suggest performing an external examination of your genitalia, or internal examination either with a speculum (medical instrument used to visualise your vagina and cervix) and/or with gloved fingers (also known as a bimanual examination). Depending on your situation, they'll discuss whether you need further tests to identify a cause and advise you on treatment options.