Intermenstrual Bleeding [IMB]

IMB refers to vaginal bleeding [other than postcoital] at any time during the menstrual cycle other than during normal menstruation. It can sometimes be difficult to differentiate true IMB bleeding from metrorrhagia [irregularly frequent periods]. 

Mostly associated with uterine cause.

Investigations

Ultrasound scan to assess thickness of lining of the womb [endometrium].

A sample of the endometrium [endometrial biopsy] is obtained to exclude endometrial pathology, including cancer, especially in women at or over 45 years of age.

Hysteroscopy may be necessary to assess the endometrium and allows removal of benign pathology at the same procedure.  This procedure may be done under local or general anaesthesia.

Treatments

Depending on the cause and the results of investigations, this may be treated by medical or surgical approach.