Definition of spotting
Spotting is a female disorder that consists of dark, abnormal and unexpected uterine discharge between one menstruation and the next. Although most of the time it remains a harmless phenomenon, a sign of stress, spotting should never be underestimated as it could be a spy. of serious pathologies.
As mentioned in the "spotting" article, the causes that cause the disorder are classified into two broad categories (organic and functional): in general, stress (an element functional) 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 each single factor could be enigmatic, even for the gynecologist.
Organic causes
The main organic factors that cause spotting include:- Premature menopause;
- Endometriosis, ovarian cysts;
- Tumor / pretumor forms (carcinoma, fibroids, polyps);
- Inflammations (vaginitis / vaginosis);
- Ectopia of the cervix.
Early menopause and spotting
Premature and early menopause are two very common 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 estrogenic and progestin alterations. It is known that menopause represents a period of considerable physical and psychological change in women, often accompanied by stress. When other factors are added to stress, such as earliness of the arrival of menopause (the fertile period ends before the age of 40), or the prematurity of the same (menopause appears between 45 and 50 years), the body struggles to find the right balance and sends alarm signals such as spotting.
In this case, the woman is in a transitional period and spotting should not overly alarm the patient; however, the advice of the gynecologist is always recommended.
Endometriosis and ovarian cysts
Another organic cause that considerably affects the manifestation of spotting is endometriosis, a very painful female disorder characterized by the presence of endometrial tissue in extra-uterine sites (endometrium ectopic), such as in the fallopian tubes, ovary and cervix. Although the endometrial tissue is located in places where it should not be, it is still sensitive to ovulatory hormonal stimuli, so the ectopic endometrium undergoes the same alterations as the uterine endometrium.
The ectopic endometrium also determines consistent menstrual irregularities and spotting, caused by a notable hormonal modulation mainly due to the flaking of the endometrium.
When spotting coincides with ovulation and the phenomenon is repeated for several cycles, the woman should promptly 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 there are also various cancers: this category includes both benign forms (polyps and fibroids), and the more serious forms, such as, for example, cancer of the neck of the "uterus.
In most cases, uterine polyps and myomas remain harmless forms, but they could cause discomfort and be the organic cause of spotting and other menstrual irregularities. Generally, the doctor prefers to excise uterine polyps to avoid the possible malignant degeneration of the tumor, unlike fibroids, which - when they do not cause discomfort or pain to the woman and do not reach excessive size - can also not be eliminated surgically, since the risk of malignant evolution is close to zero.
In the specific case of fibroids, the doctor may prescribe the woman to administer some pharmacological substances in order to prevent the dimensional evolution of the myoma.
Unfortunately, for the precancerous and cancerous forms of malignant type, the treatment is different: the spotting induced by malignant tumors is only a minimal symptom and certainly does not represent the factor that should cause the greatest alarm. Spotting, in this case, should be understood in a positive sense, since most of the time it is the first indicator of the tumor manifestation: if the cancer is diagnosed promptly, the probability of complete recovery is increased.
Analysis of cervical cells, analysis of the internal uterine cavity, biopsy and colposcopy are the possible procedures to outline a detailed diagnostic picture of the patient.
Vaginitis and vaginosis
Vaginitis and vaginosis delineate other organic causes that favor spotting: the recurrence, in the intermenstrual period, of small dark uterine blood losses could heavily affect the vaginal pH, altering and increasing its physiological value (in other words, spotting could favor the "raising the pH, making it more basic). In doing so, the physiological micro 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, emit very unpleasant odors, very annoying, as well as embarrassing).
Cervical ectopy and spotting
Among the organic causes that cause spotting, cervical ectopy also stands out, a harmless but decidedly annoying and very frequent disorder in the female world: cervical ectopy, in medical language, is known as ejection of the endocervical mucosa.
In "ectopia, the neck of the uterus (a section of the cervical lining) is directed towards the outside, implanting itself at the level of the vaginal epithelium: the phenomenon is favored by hormonal modulation.
The area affected by the ectopy of the cervix is particularly sensitive to bacterial attacks, responsible for spotting.
Prevent spotting
In addition to playing sports, following a correct diet, eliminating (or reducing) smoking, and carving out a few moments of relaxation, to prevent spotting it is recommended to pay particular attention to intimate hygiene:
- Aggressive intimate cleansers should never be used, as they are mainly responsible for an "alteration of vaginal pH: the increase in pH facilitates the onset of" infections, which are also responsible (and not only) for spotting;
- Close and frequent sexual intercourse can increase vaginal pH, creating a locus favorable for bacterial proliferation: in fact, the pH of the sperm is slightly basic (pH: about 7.4);
- Your doctor may recommend acidifying pessaries or internal vaginal creams to avoid infections and unexpected uterine discharge.
Although spotting represents a harmless phenomenon in most cases, once again it is necessary to underline the importance of the gynecological examination, right from the very first manifestations of spotting, in order to ascertain any complications in time.
Summary
- Premature menopause;
- Endometriosis, ovarian cysts;
- Tumor / pretumor forms (carcinoma, fibroids, polyps);
- Inflammations (vaginitis / vaginosis);
- Ectopia of the cervix.
The body is subject to strong estrogen-progestogen imbalances which can promote spotting
The spotting is caused by a consistent hormonal modulation given by the flaking of the endometrium
- Fibroids and polyps (benign forms): These are generally harmless, but may still cause spotting
- Carcinoma and cancer of the cervix: spotting represents, in most cases, the first indicator of tumor manifestation
The repetition of spotting could cause the physiological value of the vaginal pH to rise, favoring bacterial infections
The ectopic area of the cervix is particularly sensitive to bacterial attacks responsible for spotting
- Pay attention to intimate hygiene
- Avoid harsh intimate cleansers
- Frequent sexual intercourse can increase vaginal pH, as sperm has a pH of approximately 7.4
- Contact your doctor from the very first manifestations of spotting
