Metrorrhagia refers to uterine bleeding that is not related to menstruation, a normal uterine bleeding every 21 to 35 days which is a result of the shedding of the endometrium, the inner lining of the uterus. Any bleeding outside the normal menstruation period is a type of abnormal vaginal bleeding and a sign that something is wrong.
Metrorrhagia, sometimes referred as intermenstrual bleeding can be a sign of various disorders including an underlying medical condition but it does not necessarily indicates a serious health problem although it can be also a symptom of a cancer. Abnormal uterine bleeding is most often a result of hormonal imbalances which may cause only spotting or heavy bleeding between the menstrual periods. It is most common in girls who just started menstruating and in women in perimenopause or before menopause. Hormonal imbalances may also result in menometrorrhagia, a type of metrorrhagia which is characterized by prolonged or severe uterine bleeding that is not related to menstruation as well as in dysfunctional uterine bleeding. This condition is characterized by abnormal uterine bleeding and is commonly related to hormonal changes although the exact causes often remain unknown.
Dysfunctional uterine bleeding (DUB) is categorized into two types, known as the ovulatory dysfunctional uterine bleeding and anovulatory dysfunctional uterine bleeding. The first type of DUB occurs in women who are ovulating but the anovulatory DUB is responsible for approximately 90% of DUB. Anovulatory DUB is characterized by inappropriately developed and released egg resulting in excessive growth of the endometrium, an inner lining of the uterus. This type of DUB typically results in delayed periods which are typically heavy and prolonged. It can be caused by a large number of factors but the exact cause often remains unknown.
Very common type of metrorrhagia is also the so-called post coital bleeding which occurs after sexual intercourse but may also occur spontaneously. Another type of metrorrhagia is also the so-called mid cycle spotting. It usually occurs ten to fifteen days after the last menstruation period and is experienced by approximately 30% of girls and women at certain point of life. Mid cycle spotting usually is not indicating a serious underlying medical condition and is most often caused by hormonal imbalances. Intermenstrual bleeding and acute bleeding are sometimes used as a synonym for mid cycle spotting but both terms may also refer to uterine bleeding of different amounts between the normal menstrual periods. Metrorrhagia that occurs in postmenopausal women is known as postmenopausal bleeding.
In some cases, metrorrhagia is a side effect of certain medications but can be also a result of a withdrawal of oral contraceptives or hormone therapy. This type of metrorrhagia is known as a withdrawal bleeding.