Definition of spotting
Spotting is a female disorder that consists of dark, abnormal and unexpected uterine losses, between one menstruation and another. Although most of the time it remains a harmless phenomenon, a sign of stress, spotting should never be underestimated as it could be a sign of serious illness.
As mentioned in the article "spotting", the causes that cause the disorder are classified into two broad categories (organic and functional): in general, stress ( functional element) represents the common thread, the main cause that causes spotting and menstrual irregularities in general (eg polymenorrhea, metrorrhagia, oligomenorrhea, etc.). Precisely for this reason, the two etiological groups are often intertwined and, sometimes, the recognition of every single factor could be enigmatic, even for the gynecologist.
Organic causes
The main organic factors that cause spotting include:- Early menopause;
- Endometriosis, ovarian cysts;
- Tumor / pretumoral forms (carcinoma, fibromas, polyps);
- Inflammations (vaginitis / vaginosis);
- Ectopia of the cervix.
Early menopause and spotting
Early and early menopause are two widespread organic causes of spotting. The hormonal alteration typical of the pre-menopausal period could play tricks and cause spotting; the body of every woman responds in a completely subjective way to the estrogenic and progestational alterations. It is known that menopause represents a period of considerable change, physical and psychological in women, often accompanied by stress. When stress is added to other factors, such as the early arrival of menopause (the fertile period ends before the age of 40), or its prematurity (menopause appears between the ages of 45 and 50), the body fatigue to find the right balance and send alarm signals such as spotting.
In this case, the woman is in a transition period and spotting should not excessively alarm the patient; however, the opinion of the gynecologist is always recommended.
Endometriosis and ovarian cysts
Another organic cause that greatly affects the manifestation of spotting is endometriosis, a very painful female disorder characterized by the presence of endometrial tissue in extra-uterine sites ( ectopic endometrium), such as in the fallopian tubes, in the ovary and in the neck of 'uterus. Although the endometrial tissue is located in locations where it should not be, it remains sensitive to ovulatory hormonal stimuli, so the ectopic endometrium undergoes the same alterations to the uterine endometrium.
The ectopic endometrium also determines consistent menstrual irregularities and spotting, caused by a remarkable hormonal modulation given, mainly, by the exfoliation of the endometrium.
When spotting coincides with ovulation and the phenomenon is repeated for several cycles, the woman should immediately contact the gynecologist, as she may be suffering from ovarian cysts.
Cancer and spotting
Among the other organic causes that can affect the manifestation of spotting also include various cancers: in this category, are included both benign forms (polyps and fibroids), and more severe forms, such as, for example, the neck cancer of the 'uterus.
In most cases, polyps and uterine myomas remain harmless forms, but could cause discomfort and be an organic cause of spotting and other menstrual irregularities. Generally, the doctor prefers to excise the uterine polyps to avoid the possible malignant degeneration of the tumor, unlike the fibroids, which - when they do not cause discomfort or pain to the woman and do not reach excessive size - may not even be eliminated surgically, since the risk of malignant evolution is close to zero.
In the specific case of fibroids, the doctor could prescribe to the woman the administration of some pharmacological substances in order to prevent the dimensional evolution of the myoma.
Unfortunately, for malignant precancerous and cancerous forms, the treatment is different: spotting induced by malignant tumors is only a minimal symptom and certainly does not represent the factor that should alarm the most. Spotting, in this case, should be understood in a positive sense, as most of the time it is the first indicator of tumor manifestation: if the cancer is diagnosed promptly, the probability of complete recovery is increased.
The analysis of the cervical cells, the analysis of the internal uterine cavity, the biopsy and the colposcopy represent the possible procedures to delineate a detailed diagnostic picture of the patient.
Vaginitis and vaginosis
The vaginitis and vaginosis delineate other organic causes that favor spotting: the repetition, in the intermenstrual period, of small dark uterine blood loss could heavily affect the vaginal pH, altering and increasing the physiological value (in other words, spotting could favor the 'raising of the pH, making it more basic). In doing so, the microbial physiological bacterial population would no longer find the ideal conditions to protect the vaginal area from pathogenic bacteria, facilitating the development of inflammation (vaginitis) and vaginosis (whose losses, caused by Gardnerella Vaginalis, give off very unpleasant odors, much disturbance) annoying, as well as embarrassing).
Ectopia of the cervix and spotting
Among the organic causes that cause spotting, the ectopia of the cervix also stands out, a harmless but definitely annoying and very frequent disorder in the female world: the uterine ectopia in the medical language is known as extroflexion of the endocervical mucosa .
In ectopia, the cervix (a stretch of the cervical lining) turns outwards, implanting itself at the level of the vaginal epithelium: the phenomenon is favored by hormonal modulation.
The area affected by the ectopia of the cervix is particularly sensitive to bacterial attacks, those responsible for spotting.
Prevent spotting
In addition to playing sports, following a correct diet, eliminating (or reducing) smoking, and carving out some moments of relaxation, special attention to intimate hygiene is recommended to prevent spotting:
- Aggressive intimate cleansers should never be used, the main ones responsible for altering the vaginal pH: the increase in pH facilitates the onset of infections, responsible also (and not only) for spotting;
- The close and frequent sexual relationships can increase the vaginal pH, creating a propitious locus for the bacterial proliferation: in fact, the pH of the sperm is slightly basic (pH: about 7.4);
- Your doctor may recommend vaginal internal eggs or creams with an acidifying action to avoid unexpected infections and uterine losses.
Although spotting represents a harmless phenomenon in most cases, once again it is necessary to underline the importance of the gynecological examination, even from the very first manifestations of spotting, in order to ascertain any complications in time.
Summary
| Organic causes of spotting |
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| Organic cause of spotting: menopause | The organism is subject to strong estrogen progestagic imbalances that can promote spotting |
| Organic cause of spotting: endometriosis | Spotting is caused by a consistent hormonal modulation given by the cleavage of the endometrium |
| Organic cause of spotting: tumor forms |
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| Organic cause of spotting: vaginitis and vaginosis | Repeating spotting may cause the physiological value of vaginal pH to rise, favoring bacterial infections |
| Organic cause of spotting: ectopia of the cervix | The area affected by the ectopia of the cervix is particularly sensitive to bacterial attacks responsible for spotting |
| Spotting prevention |
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