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.

GLP-1 drugs are set to become the “new statins of the world” and could transform metabolic health, said Wasim Hanif, Professor of Diabetes and Endocrinology at University Hospital Birmingham.

Speaking exclusively to HealthandMe, Prof Hanif discussed their growing use in obesity and diabetes, potential benefits, side effects and when patients should stop treatment.

GLP-1 Drugs Could Save NHS Billions

Even as the NHS is rolling out GLP-1 drugs, including tirzepatide (Mounjaro), for severe obesity, Prof Hanif said their kidney and cardiovascular benefits could also reduce the healthcare burden.

NICE recommendations cover tirzepatide and semaglutide for obesity and type 2 diabetes, with recommendations also expected for obstructive sleep apnea and MASH.

“I think these drugs will have a huge impact. These are going to be the game changers in metabolic health. These are the new statins of the world,” he said.

The only caveat, according to him, "is the cost, especially in the West".

"The cost of these medications is too high, but the hope is that within the next couple of years, once they become generic, they'll be used even more,” the professor told HealthandMe, on the sidelines of an event organized by the BMJ Group in New Delhi.

From GLP-1 To GIP And Glucagon

The Professor explained that the drugs have evolved beyond GLP-1 alone:

• GLP-1: Drugs based on glucagon-like peptide-1
• GLP-1 + GIP: Tirzepatide
• GLP-1 + GIP + glucagon: Retatrutide

US: Obesity And Diabetes Trends Falling

Prof Hanif pointed to growing use in the US and resulting health benefits.

“The total amount that the companies made with the use of these drugs in the United States was 43 billion dollars. Now we are actually seeing, for the first time, the trends of obesity and diabetes coming down,” he said.

He added that cardiovascular benefits are also expected to have a major impact.

‘Weight Losses We Never Imagined’

Prof Hanif said the drugs are producing major clinical improvements.

“For the first time in years I'm seeing my patients with diabetes achieve normal HbA1c once these drugs are used. Secondly, we are seeing weight losses we never imagined we would be able to get,” he said.

He also highlighted improvements in:

• Obstructive sleep apnea
• Cardiovascular health
• Heart failure.

Does Everyone Need A High Dose?

Recent research showed that GLP-1 drugs are showing benefits, even with lower doses. Prof Hanif said dosing depends on the condition and patient.

“For weight loss, yes, you need bigger doses, and that depends upon what your baseline weight is. So if your BMI is 40-45, you probably require a bigger dose, but if your BMI is less, you require a lesser dose,” he explained.

“For diabetes, you don't need the higher doses. With one milligram of semaglutide or five milligrams of tirzepatide, 80% of the patients get the decision,” he said.

“For cardiovascular protection, you don't need big doses. So it really depends upon — it's not that every person will need the topmost dose.”

GLP-1 Side Effects: What Does The Data Show?

Do these drugs have side effects? Prof Hanif said yes — but stressed that side effects occur with every medication. However, he pointed out to increasing "medical misinformation about GLP-1 drugs spreading rapidly through social media and websites in the US, Asia and India".

“Between 2007 and 2025, there were 1900 cases of pancreatitis reported or associated with GLP-1, with 19 deaths in the UK. Now how many patients were using these agents? Millions,” said Prof Hanif, who is also part of the board of the UK’s Medicines and Healthcare products Regulatory Agency (MHRA).

Comparing this with metformin, he added: “During the same period of time or even less, metformin caused 25 deaths.”

Hair Loss, Muscle Loss And Retinopathy

Prof Hanif said side effects associated with GLP-1 drugs do occur, but there are strategies to mitigate them.

“Hair loss is very — it does happen, but it's not that common. Loss of muscle mass happens, but it happens with any kind of weight loss.”

“There are mitigation strategies — how you do it.”

He also highlighted retinopathy, particularly among people with diabetes.

“We know if somebody's having proliferative retinopathy or having laser treatment, you don't use it. There are guidelines on that.”

He also warned against viewing GLP-1 drugs as lifestyle drugs, and buying them online and using them without appropriate medical oversight.

“So these drugs have to be used under medical supervision by people who know how to use these drugs, like any other drugs," Prof Hanif said.

Immunotherapy isn’t always better than chemotherapy. Its benefits depend on the cancer type, stage and biomarkers. Similarly, “superfoods” do not cure cancer, health experts said while addressing comedian Rahul Dua’s claims about cancer treatment.

On a recent podcast, Dua opened up about a family member’s four-year cancer battle and his research into alternative treatments.

Dua said his family member began improving after switching from chemotherapy to immunotherapy. He also claimed that low-cost drug combinations, including ivermectin and fenbendazole, could have potential in cancer treatment and questioned whether pharmaceutical profits influence which treatments receive attention.

But what does science say? HealthandMe spoke to oncologist to fact-check these claims and address common cancer-treatment myths.

Immunotherapy Isn’t Always Better Than Chemotherapy

“Immunotherapy is not universally ‘better’ than chemotherapy. Benefit depends on cancer type, stage, and biomarkers such as PD-L1, MSI-H or TMB,” said Dr Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital.

“In melanoma, mismatch-repair–deficient tumors and selected lung or kidney cancers, immunotherapy often outperforms or usefully combines with chemotherapy. In many other cancers, chemotherapy remains the backbone,” he added.

Patients should not decide their treatment on their own, the expert told HealthandMe.

Accurate diagnosis, staging and molecular testing require a multidisciplinary team. Shared decision-making with an oncologist is essential, as self-directed treatment choices can delay effective care and cause harm.

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

‘Superfoods’ Don’t Cure Cancer

Dua also claimed that certain “superfoods” — including a high-protein, high-fat, low-fibre diet — combined with immunotherapy can cure cancer.

“‘Superfoods’ do not treat cancer. A balanced diet supports strength and treatment tolerance, but no food replaces proven therapy. Miracle-food claims lack rigorous evidence,” Dr Shyam said, stressing that patients should consult their oncologist for individualized, evidence-based care.

The Rs 50 Ivermectin-Fenbendazole Claim

Dua also spoke about a combination of ivermectin and fenbendazole, describing it as a “₹50 cancer treatment” that he believed could be more effective and questioned whether pharmaceutical profits were a factor.

“But since it was a 50 rupee cure. There is no profit for pharma in that. There is no profit for pharma in that. Off the record, there is this medicine combination of Ivermectin and Fenbendazole. Fenbendazole is a dog dewormer. It costs 20 rupees. Ivermectin is a horse dewormer. I am very convinced that as soon as my auntie moved from (4 years of) chemo to immunotherapy. (She) Started becoming better,” Dua shared during the podcast.

According to the American Cancer Society, ivermectin is not approved to treat cancer in people or animals, and no clinical guidelines recommend it as a cancer treatment.

"Ivermectin has not undergone the rigorous clinical trials needed to establish whether it is safe and effective as a cancer treatment in humans. Available research is insufficient to determine whether it could work as an anticancer drug," it says.

While ivermectin may be used at recommended doses to treat certain worm infections, large doses can be dangerous, potentially causing seizures, coma and even death. It may also worsen the side effects of standard cancer treatments such as chemotherapy.

Read More: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

Experts Warn Against ‘Miracle Cure’ Claims

Dua’s claims has drawn sharp criticism from oncologists, public health specialists and medical communicators, who warned that unscientific “miracle cure” claims could mislead patients into delaying evidence-based treatment.

“Don’t fall for this. A ₹50 cancer ‘cure’ that pharma is hiding is clickbait, not care. These people never follow it themselves and feel no responsibility when patients delay real treatment just so a video can go viral. Lives are not content,” Dr Rishabh Jain, Medical Oncologist, AIIMS Delhi, said on X.

Dr Arshiet Dhamnaskar, neurosurgeon at Western India Institute of Neurosciences, also said people not “trained in medical science should refrain from commenting upon it. As even one bit of misinformation can be disastrous.”

BBC News presenter Maryam Moshiri has opened up about her experience of living with an incurable blood cancer for the past two years.

Moshiri, 49, was diagnosed with Polycythemia Vera (PV) in November 2024. The condition affects the bone marrow and causes the blood to become thicker than normal.

While undergoing treatment, Moshiri has continued to work and has spoken about the challenges of managing her condition alongside her career.

“I love what I do. I love being where the story is. I don’t want to allow blood cancer to stop me from doing my work,” she told The Times.

Maryam Moshiri Opens Up About Living With Blood Cancer

Moshiri’s treatment involves having blood removed to reduce the concentration of red blood cells, a procedure that can leave her feeling exhausted.

She has also opened up about the challenges of continuing to work while experiencing fatigue related to her cancer treatment.

“I was working 14-hour days, constantly on air, constantly having to think on my feet, and holding it together, despite the fact that I had this chronic tiredness and fatigue,” she was quoted as saying.

“When you’re doing live news, you have this rush of adrenaline, and you just have to get on with it.”

Moshiri, who is a mother of three children aged 13, 11 and 9, also highlighted how she has struggled with constant fatigue while managing family life.

What Is Polycythemia Vera?

Polycythemia vera is a disorder in which the bone marrow produces excessive amounts of blood cells. In PV, the major problem is an overproduction of red blood cells.

An increased number of red blood cells means a higher proportion of cells are circulating in the blood. This can make the blood thicker and increase the risk of blood clots, stroke and heart attack.

Doctors therefore pay close attention to a patient's hematocrit, which represents the proportion of blood made up of red blood cells.

One of the major treatment goals is to keep hematocrit below 45%, which helps reduce cardiovascular risks.

How Is Polycythemia Vera Treated?

One of the traditional ways of controlling PV is removing some blood. The procedure, called phlebotomy, involves taking blood from a vein to reduce the number of circulating red blood cells and bring the hematocrit level down.

For some patients, this can become a recurring procedure. They may need repeated blood draws even while receiving standard treatment. This treatment burden is one reason a new drug for PV has attracted attention.

FDA Approves Drug for Polycythemia Vera

Late last month, the US Food and Drug Administration (FDA) approved Mimrylo (rusfertide) for adults with polycythemia vera (PV).

The drug is the first approved treatment for PV that mimics hepcidin, a naturally occurring hormone that regulates iron in the body.

The approval is particularly significant for patients whose disease remains inadequately controlled despite existing treatment and who need frequent blood-removal procedures.

“People living with polycythemia vera have long faced the challenge of managing a chronic blood disorder with frequent blood draws,” said Tanya Wroblewski, Director of the Division of Nonmalignant Hematology at the FDA's Center for Drug Evaluation and Research.

The FDA granted priority review and approved the drug to Takeda Pharmaceuticals America.