To Pray or Not to Pray, That is the Question? 

Our menstrual cycle! A hot topic that every woman can relate to. As Muslim women, our periods/menses/menstrual cycle are a huge concern when it comes to things like; when can we start praying and when we cannot? When can we start fasting and when should we not? What does it mean if we see spotting? What if its a specific color? The list goes on and on.  

My attempt here will be to briefly shed some light from a medical perspective, on what the menstrual cycle actually is, what to expect and how to approach various situations we might be faced with everyday.   

So let’s jump right into it, shall we?

First of all, what is the menstrual cycle? 

A full menstrual cycle is the number of days from the first day of one period to the first day of the next. So that means day one of the menstrual cycle is the first of full bleeding day of the period. A typical cycle is approximately 24 to 35 days (average 28 days for most women). 

Medically this means:

The series of changes our body goes through in preparation for the possibility of pregnancy, is the menstrual cycle. Each month, one of the ovaries releases an egg- this is called ovulation. At the same time, hormonal changes prepare our uterus for pregnancy. If ovulation takes place and the egg is not fertilized, the lining of the uterus sheds through the vagina. This is a menstrual period. When you menstruate, your body sheds the lining of the uterus wall (which would have been the womb). Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina. 

Islamically this means:

Hayd is the term for menses. Hayd (menses) literally means something that issues forth or is in running state. It refers to that flow of blood which women experience every month for a given time period. 

Ok, So what’s normal? 

The menstrual cycle, which is counted from the first day of one period to the first day of the next, isn’t the same for every woman. Menstrual flow might occur every 21 to 35 days and last two to seven days. For the first few years after menstruation begins, long cycles are common. However, menstrual cycles tend to shorten and become more regular as you get older.

For the purpose of this article, our main concern is: Menstrual flow, is the number of days you are bleeding, each month during your cycle.

Your menstrual flow can vary from being:

• regular — about the same length every month
• irregular
• light
• heavy
• painful
• pain-free
• long 
• short

At the end of the day, “Normal” is what is normal for you. 

What does that mean exactly? 

‧ There are no definite appointed days for a woman in menses. 

‧ The number of days may be more in one month and less in another. 

‧ Every woman knows what NORMAL for her. 

‧ Every woman and every month can vary.  

‧ Its not necessary for the menses to start each month on the same date. 

‧ It may start early or may be delayed. 

‧ The duration of menses will vary for all women, varying person to person. 

(Keep in mind that use of certain types of contraception, such as extended-cycle birth control pills and intrauterine devices (IUDs), will alter your menstrual cycle. Talk to your health care provider about what to expect)

(When you get close to menopause, your cycle might become irregular again. However, because the risk of uterine cancer increases as you age, discuss any irregular bleeding around menopause with your health care provider.)

Ok, but do I know what is actually normal for me? 

Number one: Keep track of your menstrual period!

To find out what’s normal for you, start keeping a record of your menstrual cycle and menstrual flow on a calendar. Begin by tracking your start date every month for several months in a row to identify the regularity of your periods.

The best and easiest way to do this in 2017 is download an app! There are a gazillion apps out there. I personally use “Period Diary.” Its a very simple basic app, that tracks your start and end date, gives you predictions, etc. 

If you’re extra concerned about your periods, then also make note of the following every month:

‧ End date. How long does your period typically last? Is it longer or shorter than usual?

‧ Flow. Record the heaviness of your flow. Does it seem lighter or heavier than usual? How often do you need to change your sanitary protection? Have you passed any blood clots?

‧ Abnormal bleeding. Are you bleeding in between periods?

‧ Pain. Describe any pain associated with your period. Does the pain feel worse than usual?

‧ Other changes. Have you experienced any changes in mood or behavior? Did anything new happen around the time of change in your periods?

My cycle is not normal or irregular, why?

Menstrual cycle irregularities can have many different causes, just a few of those include:

‧ Pregnancy or breast-feeding. A missed period can be an early sign of pregnancy. Breast-feeding typically delays the return of menstruation after pregnancy.

‧ Eating disorders, extreme weight loss or excessive exercising. Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can disrupt menstruation.

‧ Polycystic ovary syndrome (PCOS). Women with this common endocrine system disorder may have irregular periods as well as enlarged ovaries that contain

What can I do to prevent menstrual irregularities?

For some women, use of birth control pills can help regulate menstrual cycles. Treatment for any underlying problems, such as an eating disorder, also might help. However, some menstrual irregularities can’t be prevented.

In addition, consult your health care provider if:

‧ Your periods suddenly stop for more than 90 days — and you’re not pregnant

‧ Your periods become erratic after having been regular

‧ You bleed for more than seven days

‧ You bleed more heavily than usual or soak through more than one pad or tampon every hour or two

‧ Your periods are less than 21 days or more than 35 days apart

‧ You bleed between periods

‧ You develop severe pain during your period

‧ You suddenly get a fever and feel sick after using tampons

Remember, tracking your menstrual cycle can help you find out what’s normal for you and what isn’t. 

If you have questions or concerns about your menstrual cycle, talk to your health care provider!

What about SPOTTING?

Ok so we know that we cannot pray, fast, have sexual relations with out husband during menses. But what about spotting!?

This is very hot topic among all women. All of us have experienced some kind of spotting at some point or another. Spotting before periods is a frustrating bodily function that most of us may or may not understand. For all those times you had to throw out a new pair of underwear, for all those times you thought your period was over, you bathed and started praying/fasting etc, and then feel/see discharge, and for all those times you thought there was something wrong with your reproductive system, for all those times you think you need to stop praying/fasting etc, again after bathing, let’s try to set the record straight. 

First, we need to define spotting and understand how it affects you and your body.

What is that Spotting I get in between my Periods?

This is ISTIHADHA.

Like I mentioned earlier, a normal menstrual cycle occurs every 28 days, where menstrual bleeding usually lasts for about 4-7 days (+/-). Some women experience menstrual cycles for longer times, some women experience less. Spotting is the vaginal bleeding after your menstrual period has ended  and before your next period starts. You may not notice this spotting (mild bleeding), because it can be light or heavy. It can be a pink or brown spot on your underwear or toilet paper while wiping. Spotting can also be noticed as a blood spot or two, or more, and can even potentially resemble a menstrual period. Spotting can occur for many reasons, ranging from normal to abnormal. Our main concern here is, can we or can we not pray when this happens?

Let’s first recall the definition of HAYD:

HAYD (menses) literally means something that issues forth or is in running state. It refers to that flow of blood which women experience every month for a given period. Simply put, HAYD is your period. This is the time that a woman cannot pray, fast, have sexual relations with her husband. Why? Because the blood that is being expelled is your menstrual blood. Meaning it is the blood that your uterus wall is shedding, due to the fact that no fertilization of the egg occurred. It is the discarding of the endometrium. This blood contains cell debris, dead cells and waste products as your uterus sloughs off the wall/womb it had prepared in case your egg gets fertilized. And since it didn’t (meaning you are not going to be pregnant) your body sheds off that uterus lining. This is your menstrual blood. Since there are cell debris and waste products in it, this blood is considered unclean and impure. And therefore we cannot pray (or fast, etc) during this time. 

ISTIHADHA: is the name given to describe the flow of blood which is not in continuation of menses discharge. It is any blood that is discharged that is not part of menstruation. It is sometimes for a few days and sometimes it covers the rest remaining days of the month. It is a disease/illness and one suffering from it is called a “Mustahazza.” So basically this refers to the bleeding outside of the monthly menstruation. Another term for this is: Abnormal Uterine bleeding (AUB). This can be due to many reasons. Main cause for it these days is a bad diet. Unlike HAYD (menses), the state of ISTIHADHA is a state of purity. Why? Because in AUB or ISTIHADHA, the wall of the uterus is not being sloughed off. Here the main problem is due to the fragility of the blood vessels (veins) of the uterus. It can be due to a number of reasons. It is basically blood leaving from blood vessels (the veins in particular.) It is NOT due to the shedding of the uterus wall. In ISTIHADHA, the uterus wall is very much intact, and therefore this blood/spotting is NOT unclean or impure. 

Ayesha (RA) narrates: Fatima bint Abi Hubaish (RA) came to the Prophet (saw) and submitted: Oh Messenger of Allah, I am unable to attain purity from menses, should I give up prayers? Prophet (saw) informed her that it was only blood from the vein and not menses discharge. Therefore when the menses starts, give up prayers and after the usual menses have passed, wash off that blood and resume prayers. (transmitted by Bukhari)

OK so what does that mean for me, a muslim woman? 

We all know (or should know) the duration and details of our menses. If the blood/spotting continues beyond menses, it comes under ISTIHADHA. After the usual days of menstrual bleeding have passed a Mustahaaza (one experiencing ISTIHADHA/spotting/AUB) can take her bath (Ghusl) and carry on with the routine acts of Ibadah. This includes praying, fasting, and even having sexual relations with the husband.

It is important to note here, that a woman suffering from ISTIHADHA should still perform wudu before each prayer. If she wants to wear a pad, she can put a clean one on before each prayer, wudu, and pray. The discharge/spotting/ISTIHADHA that occurs while praying is fine and not considered impure. 

Fatima bint-e-Abu Hubaish (RA) relates that she had a prolonged flow of blood (after menses) and the Messenger of Allah stated to her: During menses the color of blood is dark which can be recognized and when that is the case, then avoid prayer. Otherwise, (when the color of the blood ceases to be dark) then perform ablution and observe prayer for that is the blood from the vein. (transmitted by Abu Dawood) 

A woman suffering from ISTIHADHA, can perform all worships in the usual manner after the bath (Ghusl) 

Ayesha (RA) relates: Among the consorts of purity, some performed I’tikaaf during the state of ISTIHADHA (transmitted by Bukhari) 

It is also lawful to have sexual intercourse with the wife who is suffering from Istihadha after her bath. 

Ikrima states: Umme Habiba (RA) was suffering from Istihadha. Her husband Abdur Rahman bin Auf (RA) sued to have sexual intercourse with her ( after her bath).

(transmitted by Abu Dawood)

How can I tell the difference between HAYD (menstrual) blood and ISTIHADHA (non-menstrual or AUB) blood? 

HAYD (menstrual) blood will have the following features: 

• Darker in color
• May contain clots
• Thicker (due to dead cells, cellular debris etc)
• May contain an odor
• May be warmer in temperature
• Some say there will be slight pressure

ISTIHADHA (non-menstrual) blood will have the following features: 

• Bright red in color
• Thinner (because its blood from a blood vessel)
• Usually will no odor
• It is cooler in temperature

What if I still can’t tell the difference? 

Sometimes there are situations where we cannot tell whether the blood being discharged is part of our menstrual flow or part of ISTIHADHA. Meaning sometimes our menstrual cycles (and menstrual flows) are so habitually irregular each month, that we cannot differentiate when our menstrual flow ended and when ISTIHADHA has started. And so in this situation you’ve already observed the blood for the key features (color, thickness and odor) but still cannot tell. What to do here? In this situation you must recall the date of your last normal period. It might have been several months ago, but try to recall the date of that last normal period/menstrual cycle/menstrual flow. Using that earliest date, try to calculate forward from then, when your period would occur in the subsequent months until today. And depending on that, you can determine what state you are in currently. (HAYD or ISTIHADHA) 

(I hope that made sense)

What if my menses have never been normal? 

Ok so what if you cannot even recall a time when your menstrual cycle has been normal. Meaning from the day that you first got your period, you have experienced irregular cycles. Always. In this situation you will not be able to calculate anything, because you have never had a normal cycle. In this situation, one will look to her sisters or mother (closest female blood relative) and follow their cycles. Because if anything your cycles will resemble theirs. 

What if I see brown discharge?

So now lets say, a few days after attaining purity from the menses (after ghusl, after you’ve started to pray) you see some brownish discharge. What does that mean? This is not to be assumed that your period is starting over. This brown discharge usually represents left over menstrual blood that is just being discharged a little late. Brown or even blackish discharge appears towards the end of your period. It just means that the blood is flowing out of the body at a slower rate. Older blood turns brown- or even black- and is typically not a sign that anything is wrong. This is basically the tail of your menstrual flow. If you see brownish discharge after you have taken a bath (Ghusl) you can continue to keep praying and fasting. 

Umm Atiyya (ra) relates: We did not attach any importance to brown or yellow colored water if it appeared after attaining purity from menses. (transmitted by Abu Dawood)

It’s therefore, also important to note, not to hurry into prayers and fasting. As much as we would like to get back to our daily acts of Ibadah, we should give our menses the days they deserve. Our menstrual flow usually starts out as Red/Dark red, eventually becoming Brown/black, then light brown, deep yellow and then eventually white or colorless. Its important to wait until you see the white/clear discharge before you resume praying and fasting. 

The ladies used to send to Ayesha (RA) a small box containing cotton wool which was slightly tainted yellow. Ayesha (RA) stated: Until you see clear and clean water do no hurry (in acquiring purity). From this statement Ayesha(RA) meant attaining purity from menses. (transmitted by Bukhari)

What if the bleeding just never stops? 

Hamna bint Jahash (RA) relates: 

I was undergoing constant flow of Istihadha blood and I decided to raise this subject before the Prophet (saw). According for this I waited on him when he happened to be in the house of my sister Zaineb int Jahash. I said, O Messenger of Allah! I suffer from Istihadha and on that account there is incessant and profuse bleeding which is keeping me from prayers and even fasting. What is your verdict? He said: I advise you to use a cotton wool for it will absorb the blood. I said: it will not do. He said: Place a tight apparel over it. I said: That too will not help. He said: Use cloth instead of coot wool. I said: even that has failed as the bleeding is so copious. Then, the Messenger of Allah (saw) said: I tell you two things, you may act on both or either of the two, as you wish, and that will serve you. Istihadha is a blood from the devil. Hayd condition lasts for six or seven days, that is destined by Allah. Therefore, leaving this much number of days, have a bath, cleanse yourself free to offer prayers and to observe fast. You may follow this routine in the same manner as other women do in the ordinary circumstance. (transmitted by Tirmidhi)

From this we learn that some women experience some type of bleeding at all times of the month, or even continuous profuse bleeding. It goes without saying that in these circumstances, it is important to consult your physician. But when it comes to your Ibadah, and according to the above hadith, you can do either of two things: 

‧ 6-7 days can be set as your period. Then you must bath and cleanse yourself (Ghusl), and then the rest of the 23-24 days of the month you may pray and fast. 

‧ Or you can follow the cycles of your closest female blood relatives (mother or sister)

So there you have it. I hope, انشاالله  that this kinda clarified some of your common 

questions and concerns when it comes to our menstrual cycle, spotting and praying.

Again, it is incumbent upon every woman that she track her cycle, know her period/

menstrual flow, and consult a physician for any irregularities. 

Below are some reasons for spotting along with my opinion as to whether it is considered HAYD or ISTIHADHA, and whether in that particular situation you can or cannot pray:

1. It’s your first period. EVER.

For many girls, your first few years of menstruating are very new and confusing marked by painful feelings like cramps, tampons and pads, and irregular menstrual cycles. Not only do girls experience these off-schedule menstrual periods, many girls experience spotting. This is normal and is usually just a hormonal misstep that makes our uterine lining shed at the wrong time of the month. Essentially, this means our bodies are trying to understand this new “feature” and work out all the nuances of our reproductive system and “becoming a woman.”

This would be considered HAYD, and so you cannot pray. 

2. You have done something new with contraceptives.

Many of us might use some form of birth control at some point in our lives. Spotting is a common and normal side effect if you are starting, stopping, or switching birth control medications. Estrogen helps keep the lining of the uterus in place. Changing or messing with the estrogen levels in your body as a result of varying your birth control use could lead to spotting in between periods. This type of spotting does not last for longer than 1-3 months as your body tries to adapt to the new estrogen levels. Spotting can also occur with birth controls such as an intrauterine device (IUD). An IUD is a device that is inserted into the uterus and left to prevent pregnancy. The hormones in the IUD are slowly released, which controls the menstrual cycle and reproduction abilities. However, in the first three to six months, it is very common to spot from an IUD, even if the doctor has used a hormonal or copper IUD. The spotting should subside over time though and is a completely normal side effect.

I believe the spotting here would be considered ISTIHADHA.

3. You just took the morning after pill.

Emergency contraception, AKA the morning after pill, can cause light spotting. Although it is not a side effect, the hormones in the medication (either progestin alone or progestin combined with estrogen) can cause women to bleed at off menstrual cycle times. This type of spotting is completely normal. However, it is important to note that this does not indicate you have your period, and therefore does not signify you are not pregnant.

This is ISTIHADHA. 

4. You have implantation spotting.

If you are spotting, but your period isn’t due for another few weeks, it could be because of implantation spotting. Implantation spotting, or implantation bleeding, is when a fertilized egg attaches itself on the inside wall of your uterus. When the embryo implants in the uterus, tiny blood vessels can erupt and cause the expectant mother to spot, usually a pink or brown type of discharge. Implantation spotting usually occurs before your next period and five to ten days after conception. Approximately 1/3 of women who reported having experienced implantation spotting claimed that this type of spotting was different than menstrual spotting. Reasons included the different color in the spotting (blood is darker than period blood), texture (more discharge like), and pain associated with spotting (cramps at the same time). The risk level is low, but if you are unsure if you are pregnant, consult a doctor.

This would be ISTIHADHA 

5. You are experiencing ovulation spotting.

Ovulation spotting is very regular for certain women and is nothing to be worried about. Women can notice spotting a day or two into ovulating. When you ovulate, it is common to experience light spotting, usually pale pink in color. There are several potential reasons for ovulation spotting. For example, it can be caused by the surfacing of ovarian follicles. When a follicle matures and bursts, it can cause mild pain and some light bleeding. An increase in your estrogen levels during ovulation can result in light spotting or bleeding. It is also important to note that ovulation time is when you are most fertile. Be sure not to mistake this type of spotting with menstrual spotting!

This is ISTIHADHA 

6. You are perimenopausal.

When you approach menopause, you may start to experience pink or brown spotting and even light bleeding before your period. During this transitional stage, your periods may be more irregular, sometimes heavier, and you may have occasional spotting about a week before your period. Ovulation occurs in the middle of your cycle, followed by menstruation approximately 2 weeks later. When you are in perimenopause, your hormone levels may become irregular and not follow this usual pattern. Once you enter menopause, all menstrual bleeding stops. However, if you are bleeding into this stage, it is important to consult your doctor and seek immediate attention. Hormonal replacement can be a common cause of vaginal bleeding in menopause, but spotting could also be a sign of cancer or other serious conditions that require medical attention.

7. You have vaginal dryness.

Vaginal dryness, or vaginal atrophy, is a common cause of spotting. It occurs when vaginal tissue is no longer moist and elastic, and becomes irritated due to a change in estrogen. When the production levels of estrogen are disrupted, it can cause the vagina to feel itchy, dry and irritated. Women who are in menopause tend to experience vaginal dryness more often than women who are not. This is because their ovaries are producing less estrogen, which leads to a thinner vaginal tissue layer and a reduction in the number of lubricating glands. However, that does not mean women not in menopause can experience vaginal dryness. For women who are experiencing vaginal dryness and are definitely not near perimenopause, there are many factors that can create this condition. Childbirth and its aftermath, friction during sexual intercourse, hormone treatments, contraceptives, medications such as antidepressants, and reactions to substances such as alcohol can trigger vaginal dryness. If you are still menstruating, vaginal dryness is usually nothing to worry about. If you are spotting during menopause from vaginal dryness, consult a doctor immediately.

this is ISTIHADHA 

8. You are stressed.

Stress can cause about almost anything in your body. It can create many imbalances in your body and spotting is no exception. Emotional stress (depression, anxiety, worry, insomnia) and physical stress (weight loss or gain, illness, poor diet, over exercising) can affect your period cycle. This is because extreme stress can cause your body to release more amounts of the hormone cortisol, which then causes your body to release less estrogen and progesterone. This hormonal imbalance can mess up your period cycle, and can make them irregular or late, and cause spotting in between. While exercising is a good reliever of stress, over-exercising can also cause an absence of menstruation (amenorrhea) and cause you to spot.

9. You have a decline in estrogen.

One out of ten women experience light spotting during ovulation in their menstrual cycle because of a brief decline in their estrogen levels that happens when an egg is released from an ovary. This type of spotting usually occurs about ten to fourteen days before your next period. The decline in estrogen causes women to experience brown vaginal discharge, or spotting. They can also experience cramping and slight pain.

This is ISTIHADHA 

10. You’re experiencing delayed ovulation.

If you are a woman who ovulates later in your cycle, it may lead to mittelschmerz. Mittelschmerz is one-sided, lower abdominal pain that is associated with ovulation in the middle of your menstrual cycle, usually about fourteen days before your next period. The pain lasts from a few minutes to hours, but can continue on-and-off for a few days. It usually is on the side of the ovary that is releasing an egg. Aside from mild pain, mittelschmerz can cause mild vaginal bleeding, or spotting. Delayed ovulation can also mean you have a small cyst on the surface of your ovary, which leads to the egg breaking through, causing vaginal spotting.

This is ISTIHADHA 

11. You have a delayed or partial period.

During a normal period, the blood coming from the vagina consists of old blood, endometrial lining, and dead tissue. When you have a delayed or partial period, your monthly flushing does not complete and leaves a small amount of lining behind. This lining is left in the uterus for up to a month. When this remaining tissue finally expels, it leaves behind a brownish or pinkish color, or spotting. Again, while you may be alarmed and confused, this type of spotting is normal.

As we discussed above, if this type brown spotting occurs after you have bathed (Ghusl), you can ignore it and continue to pray and fast. This would be considered ISTIHADHA.

12. You have inserted an object into your vagina or experienced a vaginal injury.

If you have just inserted something into your vagina (recent sexual intercourse, etc), you could cause spotting. If you just had sex and your vagina isn’t lubricated enough, the friction can cause you to spot.  Cervical bleeding can occur if you have deep penetration during sex. Inserting when you are too dry or too forcefully can also cause spotting.

This is ISTIHADHA 

13. You have a urethral prolapse.

The urethra is a tube that connects your bladder to the outside of your body which carries urine from the bladder to the urethral opening. Urethral prolapse occurs when the inner lining of your urethra protrudes through the opening of the urethra. Because of this, the opening of your urethra can resemble a pink donut or ball and seem larger and more swollen than normal. This can cause irritation in the vagina, causing small amounts of blood, or spotting, to occur. This is easily treatable with treatments such as estrogen cream, sitz baths, and antibiotics.

This is ISTIHADHA 

*14. You are impregnated.

If you are newly pregnant, chances are you will experience spotting. In the first few months of your pregnancy, it is normal to experience spotting due to all the new hormonal changes. If you are unsure if you are pregnant, take a pregnancy test or consult your gynecologist right away. A doctor can help guide you in the right direction for your pregnancy and confirm the spotting is normal and not caused by an ectopic pregnancy, which if not treated, can be life threatening.

This is ISTIHADHA.  

15. You have Polycystic Ovary Syndrome (PCOS).

Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance that interferes with normal ovulation and can cause abnormal bleeding, or spotting between periods. It can also cause annoying things like unwanted hair and acne. It is very common in teen girls and young women. One out of every 10 woman has PCOS. If you have PCOS, your ovaries are not getting the right hormonal signals from your pituitary gland. Without these signals, you can’t ovulate every month, which affects your menstrual cycle. This causes your period to be irregular, and spotting in between. Ask your healthcare provider if you are experiencing symptoms such as irregular periods, extra hair on your face and other parts of your body, acne, weight gain, and patches of dark skin on the back of your neck and other areas. The most common treatment for PCOS is birth control or other types of hormonal therapy.

The spotting due to this condition would be ISTIHADHA.

16. You have inflammation or infection in your cervix (cervicitis).

Cervicitis is the inflammation or irritation in your cervix. The symptoms are very similar to vaginitis, such as vaginal discharge, itching, pain with intercourse, and spotting. If the urine tube, or ureter, gets infected, you can feel pain and burning when you pee, which also can be a sign of cervicitis. Cervicitis can be caused by non-infections such as trauma, frequent douching, or exposure to chemical irritants. Cervicitis can be also by infections, such as certain sexually transmitted diseases (STDs). A doctor can diagnose and treat cervicitis in just a few days. The most common reason for cervicitis are sexually transmitted diseases, so the best prevention method is using a condom and being protected during intercourse.

ISTIHADHA

17. You have an ovarian cyst.

Spotting between periods can also be caused by ovarian cysts. Ovarian cysts are small sacs that develop in your ovaries and are filled with fluid. You may not know you have ovarian cysts until one ruptures. If one ruptures, you can experience lower pelvic pain, spotting, and severe discomfort. It is important to go immediately to the doctor if you are in extreme pain. Normally, doctors will wait and see if the cysts resolve themselves. If they don’t, they can be surgically removed.

This is usually more of an emergent case. It is considered Istihadha

18. You have Uterine Fibroids.

Uterine Fibroids (also known as leiomyomas or myomas) are noncancerous growths of the uterus that can occur during your childbearing years. They can range in size from tiny growths that are almost undetectable to the human eye, to large, bulky growths that can alter and enlarge your uterus. You can also have more than just one fibroid at a time. It is common for women to have fibroids at some point in their life, as they show no symptoms and can be so small it is undetectable. However, some women who experience uterine fibroids have symptoms such as heavy menstrual bleeding, spotting between periods, pelvic pressure or pain, frequent urination, and constipation. Although uterine fibroids are not usually dangerous, they can cause pain and discomfort and can lead to complications, such as anemia from heavy blood loss. See a doctor if you are experiencing pelvic pain that won’t go away, overly heavy, prolonged painful periods, or spotting between periods.

The spotting here is ISTIHADHA. 

Vaginal spotting between periods has many potential causes. They can be normal and just a part of life, or they can be serious and even life-threatening. It is important to understand your symptoms and body and routinely go to the doctor. 

Disclaimer: The article does not replace an evaluation by a physician and that it should not be used for personal medical decision making.

Sources:

https://www.buoyhealth.com/current/

The Book of Cleanliness: Compiled by Iqbal Kailani. Translated by Khaja Abdul

Muqtader.

https://islamqa.info/en/5595