Dam Nidah
Dam Nidah is blood that originates from the uterus. When a woman finds blood, whether a flow or a drop, which originates from the uterus, she will enter the status of Nidah- A form of ritual impurity, in no way associated with physical uncleanliness. (blood that is caused by a uterine wound will not be addressed here)
The most common cause of Nidah is Menstruation. There are, however, other causes of uterine bleeding that, would also cause one to become Nidah.
Gynecological testing, treatment procedures and surgery often cause uterine bleeding that may be Nidah bleeding. A Rabbi must be consulted to determine the Nidah status, as not all bleeding from medical intervention is actually Nidah.
Birth control methods (used only with Rabbinical determination) may cause uterine bleeding. Hormonal contraceptives may cause spotting or staining, until the body adjusts to the hormones. Some women may experience occasional breakthrough bleeding, while using hormonal contraceptives. I.U.D. insertion and removal will usually cause some bleeding from the uterus, please consult your rav before either procedure to determine how this will affect your status. An I.U.D, whether hormonal, or non-hormonal, may also cause spotting or staining until the body adjusts to this foreign object.
Pregnancy may cause uterine bleeding due to reasons that are inconsequential, or due to reasons that require medical attention. Although a woman is not menstruating during pregnancy, uterine bleeding at this time would cause her to enter the Nidah status. Any bleeding during pregnancy should be checked by a physician.
Fertility testing may cause bleeding from the uterus which may be considered Nidah. Fertility treatment using hormonal agents may cause uterine bleeding that would be considered as Nidah.
"Unexplained Uterine Bleeding" is bleeding from the uterus that has no medical known factor. This bleeding is not menstruation but it does cause the Nidah status. This bleeding may occur sporadically or cyclically.
The first line of action, when finding any unexpected spotting or staining is: DO NOT PANIC. Spotting and staining during the reproductive years is rarely a sign of dire disease. You have time to call your doctor and schedule an appointment to determine the cause of bleeding. However, if you are pregnant, please call your doctor that day. If you have heavy bleeding call your doctor or Hatzolah right away.
The next person to call is your Rav. Not all uterine bleeding causes one to enter the status of Nidah. A Rav can verify your status based on your individual circumstances. Sometimes the Rav will direct you to a certified Bodeket to determine if the blood was actually uterine in origin.
Staining and spotting are common during the reproductive years. Your physician, Rav and Bodeket are there to help you and guide you through with a minimum of stress.