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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 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.
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.
Spotting is usually harmless, but it's best to consult a doctor if:
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)
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.
Though periods differ in different people, there are some signs that point towards probable underlying conditions:
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.
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.
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.
See a doctor if intermenstrual bleeding is:
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.
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Hundreds of thousands of children are set to receive an additional vaccine under the NHS routine childhood immunisation programme. Health officials have confirmed it will be given alongside the existing MMR jab, which protects children in England against measles, mumps and rubella.
The decision follows advice from the Joint Committee on Vaccination and Immunisation and will see the current MMR jab replaced with a combined MMRV vaccine. This single injection protects against measles, mumps, rubella and chickenpox. Studies estimate that chickenpox in childhood leads to around £24 million a year in lost earnings and productivity across the UK. Alongside reducing this impact, the rollout is expected to save the NHS about £15 million each year in treatment costs linked to the illness.
Dr Claire Fuller, National Medical Director for NHS England, said: “This marks a very positive step for children and families, offering protection against chickenpox for the first time and strengthening the range of routine vaccinations we already give to help shield children from serious diseases.
“From now on, the combined vaccine covering measles, mumps, rubella and chickenpox will be offered at children’s routine vaccination appointments. This will help keep children healthier, prevent illness caused by these highly infectious viruses, and support the NHS shift from treating sickness to preventing it, while keeping more children safe and in school.”
Recent figures show that around half of children will have chickenpox by the age of four, with nine in ten catching it before they turn ten. Children who develop chickenpox are usually advised to stay away from school until all spots have crusted over, which typically happens about five days after the rash appears.
With the new vaccine in place, fewer children are expected to miss time at nursery or school. This should also reduce the amount of work parents need to take off to look after them.
Protection against chickenpox is being offered through a new combined vaccine known as MMRV, which replaces the existing MMR jab. The MMRV vaccine protects against measles, mumps, rubella and varicella, the virus that causes chickenpox.
Specialists say adding the varicella vaccine to the NHS childhood immunisation schedule will significantly cut the number of people who get chickenpox, resulting in far fewer severe cases.
While the vaccine does not guarantee lifelong immunity, it greatly lowers the chances of catching chickenpox or developing a serious form of the illness. Serious side effects, including severe allergic reactions, are extremely uncommon.
The vaccine is a live vaccine, meaning it contains a weakened form of the chickenpox virus. Because of this, it is not recommended for people with weakened immune systems due to conditions such as HIV or treatments like chemotherapy.
The change brings the UK in line with countries that already include routine chickenpox vaccination, such as Germany, Canada, Australia and the United States.
In the past, there were concerns that vaccinating children against chickenpox could lead to an increase in shingles later in life, but a large long-term study from the US has since shown this is not the case.
The Joint Committee on Vaccination and Immunisation, which advises the government, recommended the introduction of the MMRV vaccine for all children in November 2023.
The government confirmed plans to roll out the MMRV vaccine in August 2025, after new figures showed that none of England’s main childhood vaccinations reached the 95 percent uptake target in 2024 to 2025.
According to the UK Health Security Agency, 91.9 percent of five-year-olds had received one dose of the MMR vaccine. This figure was unchanged from 2023 to 2024 and remains the lowest level recorded since 2010 to 2011.
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Running to the bathroom with vomiting, diarrhea, or both is never fun. Yet “stomach bugs” are a common part of life, and norovirus is often behind these outbreaks.
Norovirus is a highly contagious virus that triggers symptoms like vomiting and diarrhea, and cases are climbing this winter. While it often makes headlines during cruise ship outbreaks, most infections occur on land, anyone can catch it.
“Originally called ‘winter vomiting disease,’ norovirus is one of the leading causes of vomiting and diarrhea in both children and adults,” explains Dr. Ava Anklesaria, a gastroenterologist at Columbia who treats multiple cases each year. “The virus is very stable in the environment, and only a tiny amount is needed to infect someone, which makes it easy to spread. Simple measures like washing your hands with soap and water for 20 seconds and avoiding contact with sick individuals can prevent infection.”
In the U.S., the CDC estimates that norovirus causes about 21 million illnesses, 465,000 emergency visits—mostly among children—and around 900 deaths annually.
Norovirus causes viral gastroenteritis, sometimes called “stomach flu” or a “stomach bug,” though it isn’t related to influenza. As per Mayo Clinic, it consists of several strains of RNA viruses that inflame the stomach and intestines, causing nausea, vomiting, and diarrhea.
Symptoms usually appear one to two days after exposure and often include:
Most people recover within one to three days, though they can still spread the virus for up to two weeks after feeling better.
Anyone can get infected. Norovirus is the leading cause of acute gastroenteritis in the U.S., affecting all ages. Young children, older adults, pregnant people, and individuals with existing health conditions are more vulnerable.
Norovirus spreads very easily. It survives well in the environment, and only a minuscule amount is enough to infect someone. In fact, just a few particles on the head of a pin can infect over 1,000 people.
Exposure can happen through:
As per the National Institute Of Health, once inside the body, norovirus targets the stomach and intestines. It inflames the lining of the gut, which disrupts normal digestion and absorption. This inflammation leads to increased fluid secretion and faster movement through the intestines, causing watery diarrhea. Vomiting occurs as the stomach reacts to the irritation.
The gut lining may also temporarily lose some of its ability to absorb nutrients and fluids, which can lead to dehydration, electrolyte imbalances, and fatigue. While symptoms usually resolve in a few days, the virus can continue to be shed in stool for up to two weeks, meaning the gut can remain a source of infection even after recovery.
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Atenolol is widely prescribed for conditions such as high blood pressure and irregular heart rhythms. While it is suitable for many adults, some people need to be especially careful before starting the beta-blocker.
NHS guidance highlights that certain medical conditions and life stages mean a doctor should be consulted first. This includes people with low blood pressure, Raynaud’s phenomenon, or asthma, among others.
The NHS advises speaking to a doctor before taking atenolol if you fall into any of the following groups:
According to official NHS advice, atenolol works by slowing the heart rate, which helps the heart pump blood around the body more easily. In addition to treating blood pressure and heart rhythm problems, it is sometimes prescribed to help prevent migraines and ease symptoms of anxiety.
The NHS notes: “Atenolol is only available on prescription. It comes as tablets or a liquid that you swallow. It can also be given by injection, but this is usually only done in hospital.”
People who take other medicines should also check with a doctor before starting atenolol, as some drugs can affect how well it works or increase the risk of side effects. This applies not only to prescription medicines but also to herbal remedies, vitamins, and supplements.
You should speak to a doctor if you take:
The NHS also states: “There’s not enough information to say that herbal remedies and supplements are safe to take with atenolol. They’re not tested in the same way as pharmacy and prescription medicines, and they’re generally not tested for how they affect other medicines.”
The dose of atenolol you need depends on the condition being treated. For high blood pressure, the usual adult dose is between 25mg and 50mg once a day, but you should always follow your doctor’s instructions. Your medication packaging will also provide guidance on how to take it.
How long you stay on atenolol varies as well. For long-term conditions such as high blood pressure, it is often taken for many years and, in some cases, for life.
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