While women are used to bleeding once a month, it can be jarring to experience unusual bleeding between periods.
As the most common infection experienced by women, many may wonder if the cause of their bleeding is bacterial vaginosis. However, while it’s a possibility, it’s much more likely to be due to something else. Let’s discuss the other possibilities of unexpected spotting and what to do if you experience unusual bleeding.
Table of Contents
- What Is Bacterial Vaginosis?
- Can Bacterial Vaginosis Cause Bleeding or Spotting?
- What Are the Common Symptoms of BV?
- What Could Be the Cause of Your Irregular Bleeding?
- When to See a Doctor?
- Key Takeaways
What Is Bacterial Vaginosis?
Bacterial vaginosis is a bacterial infection most often caused by Gardnerella vaginalis (G. vaginalis), which is the bacteria most prevalent within your vagina.
The vagina contains a rich microbiome consisting of hundreds of different types of bacteria, which all serve important purposes for keeping the vagina safe and functioning as needed. However, sometimes the microbiome’s environment is thrown off, allowing certain types of bacteria to grow out of control.
When this occurs, it is referred to as bacterial vaginosis (BV).
Can Bacterial Vaginosis Cause Bleeding or Spotting?
Vaginal bleeding or spotting is not a common symptom of BV. So, while BV may cause bleeding or spotting in very rare cases, it’s more likely to result from another condition.
However, there may be another connection between BV and spotting.
If left untreated, BV may cause pelvic inflammatory disease (PID), which results from infection of the fallopian tubes, uterus, or ovaries. Unlike BV, PID does have vaginal bleeding as a possible symptom, especially during or after sexual intercourse.
What Are the Common Symptoms of BV?
The most common symptoms of BV include:
- unusual consistency of the vaginal fluid
- thin, white, gray, or green vaginal discharge
- vaginal itching
- fishy-smelling vaginal odor
- burning when urinating
However, many people with BV (around half) do not experience any symptoms at all. Additionally, of those who have symptoms, they might be mild enough to remain undetected. In other cases, the symptoms might come and go, making it difficult to pinpoint their cause as BV.
What Could Be the Cause of Your Irregular Bleeding?
While bleeding or spotting between periods is an unlikely symptom of BV, other conditions may have this symptom.
Hormone Imbalance
Just like BV results from an imbalance in your microbiome, problems can also arise with an imbalance in your hormones. In particular, estrogen and progesterone help regulate the menstrual cycle, and any imbalance between the two may cause spotting.
Pelvic Inflammatory Disease (PID)
As discussed previously, PID is an infection of the female reproductive organs and can have bleeding as a symptom, especially during or after sex. PID, however, shares many symptoms with BV, such as unusual and foul-smelling vaginal discharge, burning when peeing, and pain in the lower abdomen.
However, in addition to bleeding between periods and during sex, those with PID may also have a fever, which can help distinguish it from BV.
Uterine Fibroids
Uterine fibroids are noncancerous growths that develop in the uterus, and they are often more common in women who have given birth. Like BV, those with uterine fibroids typically have no symptoms. However, in cases where symptoms are present, they include abnormal vaginal bleeding, such as bleeding between periods or heavier and longer periods.
If your only symptom is unusual vaginal bleeding, especially if you have given birth before, uterine fibroids are a more likely cause than BV.
Pregnancy Complications
Various complications during pregnancy, such as an ectopic pregnancy or miscarriage, can cause spotting. While spotting during pregnancy does not always indicate one of these scenarios, it is always recommended to contact your doctor immediately if spotting occurs.
Sexually Transmitted Infections (STIs)
Two STIs, gonorrhea and chlamydia, can cause bleeding. Like BV, these infections may also come with no symptoms. However, when symptoms appear, they can be similar to BV and other infections of the genital area. These symptoms include painful urination and unusual discharge.
However, with these STIs, vaginal discharge becomes yellow, whereas, with BV, it may be white, gray, or green.
Urinary Tract Infection (UTI)
While a UTI affects the urinary tract and not the vagina, it can still be a cause of bleeding, although in this case, the blood is found in the urine. Like BV, UTIs also cause painful urination, but instead of foul-smelling vaginal discharge, the urine smells bad.
Cancer
It’s less common for cancer to be the cause of bleeding, but still a possibility.
Cancer of the following organs may cause bleeding:
- vagina
- cervix
- ovaries
- uterus
Rare Causes
There are also some rare causes of vaginal bleeding, such as:
- extreme stress
- insertion of an object into the vagina
- thyroid disorders
- diabetes
- significant weight loss or gain
When to See a Doctor?
It’s recommended to see a doctor if you ever experience any irregular or unusual bleeding.
A challenge regarding the potential causes of irregular bleeding is that many of them share symptoms, making it difficult to distinguish when it is one or another. As such, it is always best to discuss your symptoms with a doctor, who can narrow down the possibilities and arrange for tests to help determine the exact cause.
Furthermore, it’s essential to seek emergency medical attention if your bleeding is accompanied by any serious symptoms, such as:
- fatigue
- pain
- fever
- dizziness
When you visit your doctor, it is helpful to have a record of your cycle, including when it begins and ends, the duration and heaviness of your flow, and how much bleeding you experience between periods.
Your doctor will likely give you a physical exam, including a pelvic exam, and may order some diagnostic tests to help determine the cause of the bleeding.
Key Takeaways
Bacterial vaginosis is an infection resulting from the overgrowth of bacteria in the vagina. It often has no symptoms, but in cases where symptoms are present, they can include unusual vaginal discharge, painful urination, and itching of the vagina. While bleeding is not a common symptom of BV, it is possible, although rare.
It’s common to mistake bleeding between periods as being from BV, since many of the more likely causes of bleeding share symptoms, or lack thereof, with BV. For instance, uterine fibroids are also unlikely to have symptoms, with bleeding the only one that may appear. In comparison, PID, UTIs, and STIs also result in painful urination, just like BV.
To determine the cause of your vaginal bleeding, it is best to speak to a doctor. With DrHouse, you can meet with a professional in just 15 minutes to discuss your symptoms and what the next steps should be to diagnose the cause of your vaginal bleeding.
Sources:
- Diop, K., Dufour, J., Levasseur, A., & Fenollar, F. (2019). Exhaustive repertoire of human vaginal microbiota. Human Microbiome Journal, 11, 100051. doi: https://www.doi.org/10.1016/j.humic.2018.11.002
- Verstraelen, H., & Swidsinski, A. (2013). The biofilm in bacterial vaginosis. Current Opinion In Infectious Diseases, 26(1), 86-89. doi: https://www.doi.org/10.1097/qco.0b013e32835c20cd
- Bagnall, P., & Rizzolo, D. (2017). Bacterial vaginosis. Journal Of The American Academy Of Physician Assistants, 30(12), 15-21. doi: https://www.doi.org/10.1097/01.jaa.0000526770.60197.fa
- Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/
- Bono MJ, Leslie SW, Reygaert WC. Urinary Tract Infection. [Updated 2022 Nov 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470195/
- Barjon K, Mikhail LN. Uterine Leiomyomata. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546680/
DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.
