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.

Supreme Court on Friday declared the right to menstrual health as part of the right to life under Article 21 of the Constitution. The court issued a slew of directions to ensure that every school provides biodegradable sanitary napkins free of cost to adolescent girls. The guidelines also ensured that schools must be equipped with functional and hygienic gender-segregated toilets. The Court directed the pan-India implementation of the Union's national policy, 'Menstrual Hygiene Policy for School-going Girls' in schools for adolescent girl children from Classes 6-12.

Read: Menopause Clinics Explained: Latest Launch By Maharashtra And Kerala Government

Supreme Court Declares Menstrual Hygiene As Part Of Right To Life: Here Are the Directions

A bench comprising Justice JB Pardiwala and Justice R Mahadevan passed the following directions:

• All States/UT must ensure that every school, whether government-run or privately managed, in both urban and rural areas, is provided with functional gender segregated toilets with usable water connectivity.
• All existing or newly constructed toilets in schools shall be designed, constructed and maintained to ensure privacy and accessibility, including by catering to needs of children with disabilities.
• All school toilets must be equipped with functional washing facilities and soap and water available at all times.
• All states/UTs must ensure that every school, whether government-run or privately managed, in both urban and rural areas, provide oxo-biodegradable sanitary napkins manufactured in compliance with the ASTM D-6954 standards free of cost. Such sanitary napkins must be made readily accessible to girl students, preferably within toilet premises through sanitary napkin vending machines or, where not visible, at a designated place.
• All States/UTs must ensure that every school, whether government-run or privately managed, in both urban and rural areas establish menstrual hygiene management corners. It must be equipped with spare innerwears, uniforms, disposable pads and other necessary materials to address menstrual urgency.

The court also issued directions for the disposal of sanitary waste. Justice Pardiwala said, "This pronouncement is not just for stakeholders of the legal system. It is also meant for classrooms where girls hesitate to ask for help. It is for teachers who want to help but are restrained due to a lack of resources. And it is for parents who may not realise the impact of their silence and for society to establish its progress as a measure in how we protect the most vulnerable. We wish to communicate to every girlchild who may have become a victim of absenteeism because her body was perceived as a burden when the fault is not hers."

Read: Menstrual Cups To Replace Sanitary Napkins In Karnataka Government Schools

Why Is This Judgment So Important?

In India, menstruation is still seen as taboo. In fact, there is a lot of shame around it. Menstrual shame is the deeply internalized stigma, embarrassment, and negative perception surrounding menstruation, which causes individuals to feel unclean, or "less than" for a natural biological process. This judgment thus is an effort to do away with the shame rooted in cultural, social, and religious taboos, which is often the reason why many girls drop out, or due to lack of awareness, develop health adversities.

Most health videos on YouTube, even those made by doctors are also not reliable medical information, found a new study, published in JAMA Network Open. The researchers reviewed 309 popular YouTube videos on cancer and diabetes and found that fewer than 1 in 5 were supported by high quality scientific evidence. About two-thirds of the view had low, very low or no evidence at all to back up their health claims.

What was more concerning is that weaker evidence often attracted more viewer than those backed with strong science. The study looked at videos which had at least 10,000 views. The lead author of the study Dr EunKyo Kang of South Korea's National Cancer Center, said, "This reveals a substantial credibility-evidence gap in medical content videos, where physician authority frequently legitimizes claims lacking robust empirical support."

"Our findings underscore the necessity for evidence-based content-creation guidelines, enhanced science communication training for health care professionals, and algorithmic reforms prioritizing scientific rigor alongside engagement metrics," Kang added in a news release.

How Was The Study Conducted?

The researchers reviewed videos from June 20 and 21, 2025, focusing on cancer and diabetes content. 75 per cent of them were made by physicians. The videos had a median count of 164,000 views and a median length of 19 minutes.

Researchers also developed a scoring system, called E-GRADE to rate the strength of science backed evidence in each video's claim.

This is how the grading system worked:

• GRADE A: high quality evidence
• GRADE B: standard quality evidence
• GRADE C: low quality evidence
• GRADE D: very low or no evidence

What Were The Results Of The Medical Videos?

• GRADE A: 19.7%
• GRABE B: 14.6%
• GRADE C: 3.2%
• GRADE D: 62.5%

The study also found that videos with the weakest evidence were 35% more likely to get higher views than videos with strong scientific evidence.

Richard Saver, a professor of law at the University of North Carolina at Chapel Hill noted that this issue is not just limited to YouTube. "Physician-spread misinformation is a long-standing problem, dating back well before the internet era," he wrote in an accompanying editorial.

Saver said some doctors continue to lean on personal experience rather than solid data, despite evidence-based medicine being regarded as the gold standard. He noted that EBM can feel like it downplays individual clinical judgment. Still, Saver stressed that more research is needed, adding that the study underscores the importance of examining the evidence behind health professionals’ claims on social media.

How Health And Me Has Helped With Medical Facts

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The World Health Organization (WHO) noted that menopause often goes unnoticed as a clinical priority, observing these unmet needs, the state governments in Maharashtra and Kerala will soon launch government-run menopause clinics. These clinics will have specialized support systems designed to offer holistic healthcare services for menopausal women within the public system.

These clinics will also have medical consultations, mental health counselling, targeted screening services and lifestyle guidance.

What Are Menopause Clinics?

Menopause clinics are specialized healthcare units, usually housed in government hospitals, urban health centres or district hospitals, that focus on both the medical and emotional needs of women transitioning through menopause. Rather than brushing menopause aside as a “natural” phase that needs little attention, these clinics offer organized, evidence-based care that goes well beyond routine outpatient visits.

At the heart of a menopause clinic is a comprehensive, integrated approach that includes:

• Clinical assessment of menopausal symptoms
• Screening for hormonal and physical health issues, such as bone health and heart disease risk
• Mental health support and psychosocial counselling
• Personalized advice on lifestyle, nutrition and mid-life wellness
• Ongoing patient education and structured follow-up

By bringing these services together under one roof, menopause clinics help women cope with day-to-day symptoms while also addressing long-term risks like osteoporosis, metabolic changes and a higher likelihood of cardiovascular disease.

What Is Menopause?

This is the natural, permanent end of menstruation defined as 12 consecutive months without a period. This typically occurs between ages 45 to 55.

Foods That May Help During Menopause

• Soy: A top source of phytoestrogens, particularly isoflavones, which bind to estrogen receptors in your body. Studies suggest soy may help alleviate hot flashes, improve cholesterol levels, and even reduce the risk of heart disease during menopause.
• Flaxseed: Packed with lignans, a type of phytoestrogen with mild estrogenic effects, flaxseed may also offer some relief.

Including these foods in your diet could help ease symptoms and reduce your risk of certain menopause-related conditions.

Why a Balanced Diet Matters

A nutrient-packed, balanced diet is the foundation of good health at any age. Prioritize:

• Vegetables and fruits: Rich in vitamins and antioxidants.
• Whole grains: Great for maintaining steady blood sugar levels.
• Lean proteins: Support muscle health and repair.
• Low-fat dairy: Provides calcium for bone strength.
• Avoid ultra-processed junk foods, excessive sugar, and unhealthy fats, which contribute little beyond empty calories.

Maharashtra Menopause Clinic

Earlier this January, the Maharashtra government rolled out the country’s first state-run menopause clinics across government hospitals and urban health facilities. The initiative was launched on Makar Sankranti, January 14, under the guidance of Minister of State for Health Meghna Bordikar.

As per official statements, these clinics are designed to offer end-to-end care in one place. Services include expert medical consultations to evaluate and manage menopausal symptoms, mental health support to address emotional and psychological concerns, and screenings for bone health, cardiovascular risk and hormonal balance. Medicines and follow-up advice are also provided during the same visit, cutting down the need for multiple referrals and repeat hospital trips.

A senior health official pointed out that while menopause is a natural life stage and not a disease, many women need consistent physical and emotional support during this transition. The strong response from women across Maharashtra highlights a long-standing gap in healthcare, where menopause-related concerns often went unaddressed due to the absence of dedicated services. With this move, Maharashtra has also set an example for other states looking to introduce gender-specific care within public health systems.

Read: Can Your Diet Affect Menopause?

Kerala follows with dedicated clinics

Taking a cue from Maharashtra, the Kerala government has announced plans to set up specialized menopause clinics in district hospitals. An initial allocation of Rs 3 crore has been earmarked for the project in the 2026 state budget, presented by Finance Minister K N Balagopal.

The proposed clinics in Kerala will follow a similar model, offering medical consultations for menopausal symptoms, mental health counselling, and screenings for heart, bone and hormonal health. Women will also receive medicines along with lifestyle and dietary advice at a single facility.

The initiative acknowledges the wide-ranging impact of menopause, including hormonal changes, sleep disturbances, bone health issues and increased stress, and aims to create a one-stop support system within district hospitals. By bringing menopause care into mainstream public healthcare, Kerala hopes to improve access, reduce stigma and ensure that women receive timely, structured support during this phase of life.