Dear Hubby,
Occasional spotting (bleeding between periods) can be very normal in women of all ages. Your wife may be experiencing "mittleschmerz" (German for middle pain). During the ovarian cycle, with the help of hormones, about ten to twenty of the thousands of follicles within the ovary begin to mature. One of these follicles develops an egg that can be fertilized. Eventually, the follicle and ovarian surface open up to let the egg float out. Women respond differently to this phase of the cycle, called ovulation. Some women feel a slight pain or cramp, some release a vaginal discharge that can include blood, some get headaches, gastric pain, and/or feel lethargic, and some women feel nothing at all. The pain and/or discharge is called "mittleschmerz."

However, it is recommended that when a female experiences spotting between cycles, that she see a gynecologist or nurse practitioner to make sure that her breakthrough bleeding is normal and not a symptom of another problem, including endometriosis, uterine fibroids, cervical cancer, or ovarian cysts. Your wife's fears about developing cancer are not uncommon. Although approximately two-thirds of women do not get cancer, media exploitation, realistic and falsified stories about cancer treatment, and the fact that about sixty percent of cancer victims die, are enough to make a woman shudder at any possible variation from her body's normal state. A complete examination and discussion with her doctor should alleviate your wife's fears about cancer.

You asked "when should she really be concerned about cervical cancer?" If caught in its early stages, cervical cancer is one hundred percent curable. It would be wise for your wife, and all women, to get a pap smear and gynecological exam annually, so that abnormal cells can be detected and treated as early as possible, and avoid chronic and potentially debilitating problems.

Alice

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