Why am I Bleeding 2 Weeks After My Period?

TEAM KNIX / YOUR BODY

Most people experience a menstrual cycle that is on average 28 days long, which means (roughly) monthly periods. The first day of your cycle is counted from the first day of your period. 

If you’re bleeding 14 days after your last period it could be that you have a shorter menstrual cycle. Or, it could be non-period bleeding. Let’s explore! 

 

What Could Cause 2 Periods in One Month?

The average menstrual cycle is 28 days long. But that doesn’t mean that everybody’s cycle runs like clockwork. Some of us have shorter or longer cycles. And some women have very irregular periods.

Also, it’s worth noting that even if your cycle is around the average 28 days, most months are slightly longer. This means your period won’t begin on the same date every month and, over time, will shift to an entirely different time of month. 

The combination of:

  • A slightly shorter menstrual cycle, plus 
  • A period that falls at the start of one month could result in two periods occurring within the same calendar month.

A shorter or irregular menstrual cycle may be caused by:

  • Anovulation: The lack of ovulation in a menstrual cycle.
  • Hyperthyroidism: An overactive thyroid may cause an irregular cycle.
  • Hypothyroidism: An underactive thyroid may also cause irregular bleeding.

 

Is it Really a Second Period?

But if you’re bleeding 14 days after your last period, don’t jump to the conclusion that it’s necessarily a second period. There are many possible causes of bleeding between periods or intermenstrual bleeding

It’s definitely worth noting just how much bleeding is occurring and understanding whether you’re spotting or bleeding. In general, spotting would mean a few drops of blood on your underwear or toilet paper. You might want to wear a panty liner or Leakproof Underwear, but odds are you wouldn’t require a tampon or pad.

If you’re bleeding more heavily, to the point where you need a pad or tampon, it’s worth consulting a doctor to understand whether the bleeding is menses (a period) or has another cause. Unusual blood loss is a cause for concern, and could result in, or exacerbate, anemia. 

But what could those causes be? Given the specific timing of the question, there is one very likely cause: Ovulation.


The Likeliest Cause: Ovulation


You ovulate about day 14 of your cycle. For many women, the day around ovulation goes completely unnoticed. But for some, ovulation is an event they may feel and notice other symptoms around. Those symptoms can include light spotting.

During reproductive ages, the ovary releases an egg every month. This event occurs when the ovary follicles rupture and release the oocyte which travels to the fallopian tube and becomes an ovum or egg. The rupture of the ovary follicles can cause some light spotting and some women can even feel it happen.

That feeling usually manifests as a slight twinge or pain on one side of your abdomen. This pain is called Mittelschmerz. It translates literally as “middle pain”. It’s the name for the slight twinge or cramp that some women experience when the follicle releases the egg.

Learn more about what happens when you ovulate.

The best way to understand whether your bleeding corresponds with ovulation is to track your cycle using an app or diary. If you’re experiencing bleeding that does not coincide with ovulation, there are many other possible causes. 

 

Other Causes of Bleeding and Spotting Between Periods

Below is a list of the most common reasons you might be bleeding or spotting between periods. While this list is not exhaustive, it does cover the most likely explanations.

Birth Control Causes

  • Birth Control Pills: According to Medical News Today, irregular bleeding between periods often occurs in the first 6 months of taking a new birth control pill. Doctors sometimes refer to this as breakthrough bleeding.
  • Morning-After Pill: According to the Mayo Clinic, the morning-after pill can cause bleeding between periods or heavier menstrual bleeding.
  • Intrauterine Device (IUD): Some women with an IUD for birth control may also experience non-period bleeding.

External Causes

  • Trauma or Medical Examination: If you’ve experienced rough sex or a medical exam, like a Pap test, you may also experience vaginal bleeding.
  • Medications: Certain medications may cause abnormal vaginal bleeding. Your pharmacist should advise you of any side-effects of medication.
  • Stress: Increased stress may trigger many reactions.

Common Infections

The following infections may cause bleeding between periods. It’s worth noting that most infections are treatable. However, infections can become more serious if symptoms are ignored.

  • Sexually Transmitted Infection (STI), including chlamydia, gonorrhea, and genital warts.
  • Pelvic Inflammatory Disease (PID), an infection of the upper part of the female reproductive system.

Pregnancy-Related Causes

  • Implantation bleeding: After a sperm fertilizes an egg, the fertilized egg implants in the womb. Sometimes, implantation may cause spotting known as implantation bleeding.
  • Ectopic Pregnancy: Signs and symptoms of an ectopic pregnancy include abdominal pain and vaginal bleeding.
  • Pregnancy: According to the American Pregnancy Association, 20% of women experience spotting during the first 12 weeks of being pregnant.
  • Miscarriage: Heavy spotting is one of the symptoms of miscarriage.
  • Breastfeeding: Depending on the frequency of breastfeeding and your own individual hormone levels, spotting may occur before full periods return.

Other Causes

  • Fibroids or Polyps: Symptoms of these benign tumours can include irregular or heavy periods and heavy bleeding between periods.
  • Endometriosis: According to the Mayo Clinic, women with endometriosis may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
  • Polycystic ovary syndrome (PCOS): PCOS can cause cysts in the ovaries and make it difficult to get pregnant. It can also cause irregular vaginal bleeding.
  • Blood clotting disorders, like von Willebrand disease.
  • Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease.
  • Cancer: Cancer or pre-cancer of the cervix, uterus, or (very rarely) fallopian tube can cause spotting or abnormal bleeding.

Perimenopause & Menopause

  • Perimenopause: The time before menopause is known as perimenopause. During perimenopause, hormone levels fluctuate greatly. These hormonal shifts can have an effect on ovulation and your entire menstrual cycle. Some women notice irregular or skipped periods and abnormal bleeding between periods during perimenopause. 
  • Vaginal dryness: Especially due to lack of estrogen after menopause, can cause bleeding.
  • Cancer: According to the Dana-Farber Cancer Institute, spotting in post-menopausal women can, in some cases, be an early sign of cancer and should always be investigated further.


Risks

Depending on the cause of intermenstrual bleeding, the risks to your health will be different.

However, anemia is one risk that is common to all causes, especially those that result in heavy bleeding and particularly when paired with heavy periods.

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. It can have many causes, including heavier menstrual bleeding (menorrhagia) or by bleeding between periods (metrorrhagia).

Anemia doesn’t always have symptoms. But, according to the Mayo Clinic, some signs and symptoms of anemia include:

  • Fatigue
  • Weakness
  • Pale or yellowish skin
  • Dizziness or lightheadedness

When to Seek Medical Advice

If bleeding is accompanied by any of the following symptoms, it warrants getting some medical advice.

  • Heavy periods with a lot of clotting
  • Irregular periods
  • Abdominal pain or cramping
  • Pain or a burning sensation when peeing
  • Unusual vaginal discharge and/or redness and itchiness

Even if you don’t have any of the above symptoms, don’t ever ignore abnormal vaginal bleeding or abnormal uterine bleeding in the following situations:

  • If you think you’re pregnant: You should always see a doctor as soon as you think you may be pregnant to be administered a pregnancy test.
  • When it happens inconsistently: If spotting seems to happen frequently and randomly, you should definitely look into it.
  • It begins after unprotected sex: Unprotected sex can put you at risk for STI’s and other infections so if you notice spotting after unprotected sex, it’s wise to visit a doctor.
  • You are on medication: If spotting can be a side-effect of any medication you are on, you should seek out professional help.
  • Spotting occurs post-menopause: It is never considered normal for anybody post-menopause to experience spotting or vaginal bleeding.

Track Your Cycle in a Journal or App

If you suspect you’re bleeding at regular intervals, it’s a really good idea to start tracking your cycle in a journal or app. This can help you understand the rhythms of your own body. Remember, everybody has their own cycle and flow and it may be affected by many factors, both internal and external.

When you’re tracking, pay attention to bleeding, but also other symptoms, including:

  • Vaginal discharge
  • Cramps or abdominal pain
  • Breast tenderness 

You can even make notes about sudden increases in libido or mood changes. Remember that bleeding may be a symptom of many different causes.

If bleeding continues, seek medical advice. Have  the information you've tracked in your diary medically reviewed by your doctor. This will help you speak to your doctor with more certainty and provide them valuable information to help with a diagnosis.