A woman's health is intricately linked to her menstrual cycle, which is an important sign of her overall well-being. Throughout puberty and menopause, hormonal changes affect not only fertility but also mood, energy, and long-term health. A normal cycle usually indicates balance, whereas abnormalities may suggest problems such as PCOS, endometriosis, or thyroid disease.

Our bodies do not always work in a perfect clockwork operation and unexpected vaginal bleeding can often confused us. Is it a mere spotting? A normal period? A symptom of something more concerning? Differences between spotting, menstrual bleeding, and intermenstrual bleeding should be understood is crucial for maintaining reproduction health.

Here is a short guide to help you differentiate while you are confused.

Spotting

Spotting is vaginal bleeding that doesn't happen as part of your regular menstrual period. It commonly manifests as fine droplets or smears of blood on clothing or toilet tissue. The intensity of the blood ranges from deep red (recent blood) to pink (having cervical mucus mixed in it) or brown (older, oxidized blood). Spotting is not very much and can't be seen in a way that needs either a tampon or a pad to absorb.

Common Causes of Spotting

Spotting is caused by numerous factors, and in the majority of instances, it is nothing to worry about. Some frequent causes are:

Hormonal Birth Control Transitions: New birth control technique, for instance, birth control pills, IUDs containing hormones, or implants, results in temporary spotting as the body adapts.

Ovulation Bleeding: A few individuals get spotting light around the time of ovulation as a result of hormonal changes. It normally happens in the mid-cycle and could be followed by slight cramping.

Cervical Ectropion: A harmless condition when cells from the inside of the cervical canal migrate to the outer cervix, causing the outer cervix to become more sensitive and prone to faint bleeding on coitus or physical activity.

Early Pregnancy (Implantation Bleeding): 15–25% of pregnant women experience light spotting around 10–14 days post-conception, which is confused with an early period.

When to See a Doctor

Spotting is usually harmless, but it's best to consult a doctor if:

• It continues after a few months of initiating new birth control
• Is accompanied by pelvic pain or abnormal discharge
• Occurs after frequent intercourse
• Occurs during pregnancy and is not verified as implantation bleeding

Menstrual Bleeding

There is a time, also known as a period or menstruation, when the uterine lining sheds due to changing hormone levels. It would last for approximately 2-7 days and is heavier initially. The hue and texture of period blood shift during the menstrual cycle:

Red: New active bleeding at the start of a period

Brown or dark red: Older, slower blood in leaving the uterus

Clots: It's normal to have small clots, but bigger clots may be a sign of heavy menstrual bleeding (HMB)

Why You Have a Period Essentially?

Menstruation is a part of the reproductive cycle, and it happens around every 21–35 days. When there's no pregnancy after ovulation, hormone levels fall, causing the uterine lining to be shed.

Signs Your Period May Be Abnormal

Though periods differ in different people, there are some signs that point towards probable underlying conditions:

• Prolonged bleeding (longer than 7 days)
• Heavy flow necessitating pad/tampon changes every 1–2 hours
• Severe cramps that disrupt daily life
• Irregular periods or absent periods

If you have any of these, conditions such as polycystic ovary syndrome (PCOS), endometriosis, or thyroid disease may be involved, and a medical visit is in order.

Intermenstrual Bleeding

Unlike spotting, intermenstrual bleeding is heavier and unexpected between regular periods. It may be from bright red to dark brown and can contain blood clots.

Possible Causes of Bleeding Between Periods

Sexually Transmitted Infections (STIs): Chlamydia and gonorrhea can lead to inflammation and abnormal bleeding.

Pelvic Inflammatory Disease (PID): A bacterial infection of the reproductive organs and can lead to abnormal bleeding.

Uterine Fibroids or Polyps: Benign growths in the uterus that may cause unexpected bleeding.

Endometrial Hyperplasia or Cancer: In some instances, abnormal bleeding may be a sign of abnormal cell growth in the lining of the uterus.

When to See a Doctor

See a doctor if intermenstrual bleeding is:

• Frequent or persistent
• Associated with pelvic pain or discomfort
• Associated with abnormal discharge, fever or painful sex

Recognizing your body's rhythms can assist you in identifying normal versus abnormal bleeding. Monitoring your menstrual cycle through an app or calendar may flag changes that should be checked with a doctor. If you have any questions regarding abnormal bleeding, visiting your health care provider is the way to go.

Fewer people are dying of heart disease, however, as per a new report from the American Heart Association (AHA), it is still the leading cause of death in the US. While the report noted a drop in rates of deaths by heart diseases for the first time in five years, the report also noted that it kills more American than any other condition. The report was published early Wednesday in the journal Circulation.

What Did The AHA Report Reveal?

The report found that annual rates of heart disease deaths have in fact decreased by 2.7% between 2022 and 2023. This means it went from 941,652 to 915, 973. However, cardiovascular diseases still killed more people in the US than cancer and accidents combined.

The report found that deaths caused by blockages in the coronary arteries, the blood vessels supplying the heart, fell by 5.9%, dropping from 371,506 to 349,470 over the same period. Coronary artery disease, a major cause of heart attacks, still claims two lives every three minutes. Other vessel-damaging chronic conditions also remain widespread.

The report found that the share of U.S. adults with high blood pressure edged up to 47.3%, while overall obesity rates dipped slightly to 50%. However, obesity is increasing among children and teenagers, rising from 25.4% to 28.1% in those aged 2 to 19.

Prevention remains the most powerful tool to reduce heart disease deaths, experts say. Because heart disease cannot be cured, waiting for symptoms often means focusing only on treatment rather than stopping the problem early. Early prevention, by contrast, has a much bigger impact on saving lives.

The report highlights four key lifestyle habits for heart health: eating a balanced diet, staying physically active, getting enough sleep and avoiding tobacco. It also stresses four important health measures: managing weight, cholesterol, blood sugar and blood pressure.

Together, these eight factors could prevent up to 40% of heart disease deaths and cut the risk of developing serious heart disease symptoms by as much as 74%. These same habits also benefit the brain, helping slow brain ageing and lower the risk of dementia, especially by keeping blood pressure under control.

Heart Health Is Also an Economic Issue

Cutting down cardiovascular disease in the U.S. would not only help people live healthier lives, it could also ease the strain on the economy, experts say. Heart disease carries a massive financial cost, with an estimated $414.7 billion spent each year on direct treatment and indirect losses between 2021 and 2022.

Even though the benefits of healthy habits are well known, getting people to prioritize heart health remains difficult. Only one in four U.S. adults meets national guidelines for both aerobic and muscle-strengthening exercise. Control of chronic conditions is also lacking, with less than half of Americans with type 2 diabetes managing their disease effectively.

Experts stress that regular physical activity, tailored to individual ability, can make a real difference. Simple, consistent movement and timely health checkups can go a long way in protecting both personal health and the wider economy.

Britons who regularly take a commonly used supplement are being urged to cut back if they notice four particular symptoms, as excessive intake can be dangerous and, in some cases, life-threatening. Vitamins and minerals are essential for keeping the body functioning properly. While most nutrients should ideally come from a healthy, balanced diet, many people choose to top up their intake with supplements.

Iron is one such supplement. This mineral plays a key role in making haemoglobin, the substance in red blood cells that carries oxygen around the body. When iron levels are too low, it can lead to iron deficiency anaemia. This condition may cause symptoms such as constant tiredness, low energy, shortness of breath, and heart palpitations. To avoid this, some people turn to iron supplements.

Could You Be Overdoing Iron Supplements?

The NHS has issued guidance on its website, warning that taking “too much” iron can cause side effects. These include:

• Constipation
• Feeling sick
• Being sick
• Stomach pain

If these symptoms appear, it may be a sign that your iron intake needs to be reduced. In children, taking too much iron can be particularly dangerous and may even be fatal.

The NHS states: “Very high doses of iron can be fatal, particularly if taken by children, so always keep iron supplements out of the reach of children.” For adults, a high dose of iron is classed as more than 20mg.

How Much Iron Do You Need?

• 8.7mg a day for men aged 19 and over
• 14.8mg a day for women aged 19 to 49
• 8.7mg a day for women aged 50 and over
• Women who continue to have periods after the age of 50 may need the same amount of iron as women aged 19 to 49

The Department of Health and Social Care (DHSC) says that “most people” should be able to meet their iron needs through a varied and balanced diet. But for those who do take supplements, the NHS advises: “Do not take too much as this could be harmful.”

It adds that taking 17mg or less of iron supplements each day is “unlikely” to cause harm. The guidance continues: “But continue taking a higher dose if advised to by a GP.”

Good sources of iron include:

• Liver (but this should be avoided during pregnancy)
• Red meat (though the DHSC advises limiting red and processed meat due to a possible link to bowel cancer)
• Beans, such as red kidney beans, edamame beans, and chickpeas
• Nuts
• Dried fruit, including dried apricots
• Fortified breakfast cereals
• Soybean flour

Symptoms Of Iron Deficiency Anaemia

• Tiredness and low energy
• Shortness of breath
• Noticeable heartbeats, also known as heart palpitations
• Skin that appears paler than usual
• Headaches
• Ringing, buzzing, or hissing sounds in the ears or head, known as tinnitus
• Food tasting unusual
• Itchy skin
• A sore tongue
• Hair loss, with more hair coming out during brushing or washing
• Craving non-food items such as paper or ice, a condition called pica
• Difficulty swallowing, known as dysphagia
• Painful open sores at the corners of the mouth
• Changes to the nails, including spoon-shaped nails
• Restless legs syndrome

People in the UK who take a commonly prescribed medication are being reminded to follow a strict cut-off time. Ignoring this guidance could lead to disrupted sleep.

What Is Bumetanide?

Bumetanide is a diuretic, a type of medicine that helps the kidneys remove excess salt and water by increasing urine production. In the UK, it is prescribed for heart failure, a condition that affects close to one million people. Bumetanide is only available with a prescription and comes in tablet form as well as a liquid that is taken by mouth.

Bumetanide: NHS Says Avoid Taking It After 4 PM

The NHS website lists several key points patients should be aware of when using bumetanide. One of the most important relates to timing. According to NHS advice, bumetanide should not be taken after 4pm, as doing so may cause frequent urination during the night.

The NHS states: “Do not take bumetanide after 4pm or you may have to wake up in the night to go to the toilet.” Alongside this warning, the guidance also includes recommendations on when to take the medicine and what foods to avoid.

“You'll usually take bumetanide once a day, in the morning or afternoon – or twice a day, in the morning and afternoon,” the NHS explains. “Most people need to pee about 30 minutes after taking bumetanide, and again within a few hours.” The NHS also advises avoiding foods high in salt, such as processed foods or ready meals, as well as salt substitutes like Lo Salt, as these can interfere with how the medicine works. However, it adds: “You can take bumetanide with or without food.”

Some people are advised to take extra care when using bumetanide. The NHS says it is important to inform your doctor if you have:

• Ever had an allergic reaction to bumetanide or other medicines
• Low blood pressure (hypotension)
• Signs of dehydration, including thirst, a dry mouth, or dark-coloured urine
• Liver disease
• Diabetes
• Difficulty passing urine
• Gout

If you are due to have a glucose test, you should also let your doctor know that you are taking bumetanide.

Bumetanide: Common Side Effects

There are several common side effects associated with bumetanide that occur in more than one in 100 people. The NHS says there are ways to manage these symptoms:

• Needing to urinate more often than usual
• Feeling thirsty
• Dry mouth
• Headaches
• Feeling dizzy or confused
• Muscle cramps or muscle weakness

Patients are advised to speak to a doctor or pharmacist if the suggested coping measures do not help, or if side effects continue or worsen after a few days.

Bumetanide: Serious Side Effects

Serious side effects are uncommon, according to the NHS. However, you should contact your doctor or call 111 immediately if you experience:

• Unexplained bruising or bleeding, a high temperature, sore throat, or mouth ulcers, which may indicate a blood disorder
• Ringing in the ears (tinnitus) or hearing loss

The NHS also notes: “In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to bumetanide.” In 2023, the UK faced a national shortage of bumetanide, which was expected to ease in 2025.

Because of this shortage, many patients were switched to furosemide, another diuretic that is also subject to the same 4pm timing advice.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider regarding any questions about medications, health conditions, or before making changes to your treatment plan.