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In some patients it gives a clue to the diagnosis of systemic disorders

Other possible causes include: Uterine fibroids Perimenopause Ovulation spotting Stress or major lifestyle changes Injury or irritation from tampons, intercourse, or medical devices While occasional spotting may be harmless, persistent or unexplained bleeding should be evaluated by a healthcare professional

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10.1158/1535-7163.MCT-07-2400 274 YuJ.PengY.WuL.-C.XieZ.DengY.HughesT.et al (2013)