Intermenstrual bleeding (IMB) is to referred to as vaginal bleeding during the menstrual cycle at any time other than when you are in your normal menstruation. Usually, a lot of people find it hard to differentiate between Intermenstrual bleeding (IMB) from metrorrhagia (known as frequent periods).
This type of bleeding usually occurs after having sex and it is not a menstrual bleeding.
This bleeding is associated with hormonal contraception and it is irregular.
Both Intermenstrual bleeding (IMB) and Postcoital bleeding (PCB are symptoms, and occur commonly. Even though the genital tract malignancy is usually not the cause of the bleeding, it should be a point of consideration in all patients even though it is a rare cause in younger women.
- It is pregnancy related, also include ectopic pregnancy.
- It is physiological, with 1-2% spot around the ovulation, and hormonal fluctuation during/around perimenopause.
- It can be a virginal cause, this includes adenosis, vaginitis, and tumors.
- It can be caused by cervical infection, cancer, cervical polyps, cervical ectropion and condylomata acuminata of the cervix.
- It can be caused by uterine, this includes fibroids, endometrial polyps, cancer, endometritis, and adenomyosis.
- It can be caused by estrogen-secreting ovarian cancers.
- It can be caused by latrogenic, this includes tamoxifen, treatment of the cervix, when oral contraceptive pills are missed, drugs which alter clot parameters (eg anticoagulants).