Can Exercise Cause Breakthrough Bleeding?

If you ever experience breakthrough bleeding after exercise, it can be scary. Bleeding during your normal menstrual cycle is — well, normal. But vaginal bleeding when you're not on your period must signal that something is really wrong, right?

Before you freak out, rest assured that breakthrough bleeding — often categorized as abnormal uterine bleeding (AUB) or dysfunctional uterine bleeding (DUB) — usually isn't anything to worry about. But if it's a side effect of too much exercise or another medical concern, then you need to address the problem that's causing it.

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According to the U.S. National Library of Medicine, abnormal uterine bleeding between periods is something that happens to most women. This could include bleeding or spotting between periods or even bleeding for more days than normal or having a menstrual cycle with fewer than 28 days between periods, among many other bleeding abnormalities. Harvard Medical School explains that this is a result of the hormones that trigger the normal menstrual cycle being thrown off.

And yes, excessive exercise or changes to your exercise routine can be a cause, along with other factors like weight loss, stress, illness, medications or even hormonal abnormalities. In some cases, the American Academy of Family Physicians notes, bleeding can occur at any point during your cycle — which could include spotting after exercise in between periods.

It's possible that what looks like bloody discharge after exercise could actually be rectal bleeding or blood from urine. To rule out these alternatives, the Mount Sinai Health System recommends inserting a tampon into your vagina to ensure that's where the blood is coming from.

KidsHealth explains that this abnormal bleeding isn't an emergency, but it could point to other problems. In some cases, girls with abnormal bleeding might be prone to anemia, and their doctor might prescribe them iron pills. It's also possible that breakthrough bleeding after exercise is happening because exercise is being done in excess and putting stress on the body.

Exercise and other physical stress can be among the causes of abnormal bleeding. Although exercise is an important part of a healthy lifestyle, KidsHealth warns that people can experience compulsive exercise or an exercise addiction. This can happen when a person puts too much pressure on themselves or feels too much pressure from a coach, teammate or parent. People who compulsively exercise won't skip a workout even if they're tired or injured, and they will have anxiety or guilt when they take days off.

If the stress from compulsive workouts is so extreme that it's causing breakthrough bleeding after exercise, you should talk to a doctor or therapist about getting help. This will likely entail treating injuries, getting rest, reducing your amount of exercise, creating alternative workout routines, and treating mental illnesses that might accompany compulsive exercise, such as disordered eating, depression or obsessive-compulsive disorder.

Although it's possible for excessive bleeding to come from too much exercise — the opposite problem can also occur, and female athletes can see their menstrual cycle stop altogether. KidsHealth offers more insight from Larissa Hirsch, MD, in discussing the case of "Samantha," who exercised for two hours every day. When her period stopped, Samantha worried it might have been because of too much exercise.

Hirsch explains that excessive exercise, fast weight loss and even malnutrition can cause a period to stop. Because Samantha had lost 26 pounds in three months, there was a chance that she wasn't taking in enough calories to keep up with her exercise routine.

Hirsch's advice in this kind of situation is to see a doctor to ensure there's nothing else wrong and to find ways to increase caloric intake and cut back on exercise. These steps will help get the menstrual cycle back to working the way it is supposed to.

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