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Why Am I Spotting Between Periods?

Spotting before your period is generally harmless. It may be an indicator of pregnancy or due to ovulation, perimenopause, polyps, or another health condition. Spotting is light vaginal bleeding that occurs outside of your regular period. Spotting typically involves small amounts of blood. You may notice it in your underwear or toilet paper after using the restroom. If you need protection, it usually only requires a panty liner, not a pad or tampon. Bleeding any time other than when you have your period is considered abnormal vaginal bleeding, or intermenstrual bleeding. Spotting has many causes. It can sometimes be a symptom of an underlying problem, but not often. You may need medical attention if you have heavy bleeding, severe pain, or if you're spotting after you've gone through menopause. Keep reading to learn why you might be spotting between periods and when to see a doctor. What causes spotting before periods? Reasons you may experience abnormal vaginal bleeding before your period may include: Pregnancy Spotting during pregnancy is common. About 15 to 25% of pregnant people experience spotting during their first trimester. The bleeding is often light and may vary in color between: pink red brown Spotting typically isn't a cause for concern, but you should tell a doctor if you have it. Contact a doctor right away if you experience heavy bleeding or pelvic pain, which can indicate miscarriage or an ectopic pregnancy. Birth control Spotting can be caused by hormonal birth control, such as: pills patches injections rings implants IUDs Spotting can happen spontaneously as a side effect or if you: Doctors sometimes prescribe certain forms of birth control to manage abnormal bleeding between periods. Talk with a doctor if your symptoms don't improve or get worse. They may prescribe a different birth control method. Ovulation Ovulation spotting is light bleeding that occurs around the time in your menstrual cycle when an ovary releases an egg. This typically occurs 14 days before menstruation. Ovulation spotting may be light pink or red and last 1 to 2 days in the middle of your cycle. Other symptoms of ovulation may include: increased cervical mucus cervical mucus with the look and consistency of egg whites a change in the cervix's position or firmness a decrease in basal body temperature before ovulation, followed by a sharp increase after ovulation increased sex drive a dull ache or pain on one side of the abdomen breast tenderness bloating an intensified sense of smell, taste, or vision If you are trying to become pregnant, tracking these symptoms may help you identify your fertile window. Perimenopause As you transition to menopause, there may be months when you don't ovulate. This transitional time is called perimenopause. This typically starts between ages 45 and 47. During perimenopause, periods become irregular, and you may experience spotting. You may also skip periods or have menstrual bleeding that's lighter or heavier than usual. Cancer While uncommon, certain cancers can cause abnormal bleeding or spotting. They can also cause other forms of vaginal discharge. These cancers may include: endometrial (uterine) cancer cervical cancer ovarian cancer vaginal cancer Spotting is not often an indicator of cancer, but you should talk with a doctor if you experience it, especially if you're over age 45 or have already been through menopause. Implantation bleeding Implantation spotting may occur when a fertilized egg attaches to the inner uterine lining. If implantation spotting does occur, it will often happen a few days before your next period begins. Implantation bleeding is usually light pink to dark brown. It can be shorter and lighter in flow than a typical period. Other symptoms can include: headache nausea changes in mood light cramping breast tenderness lower back pain or ache fatigue Implantation bleeding isn't dangerous to you or your pregnancy. But you should seek medical attention if you experience heavy bleeding while pregnant. Trauma Trauma to the vagina or cervix can sometimes cause irregular spotting. Examples of trauma can include: rough sex an object, such as a tampon a procedure, like a pelvic exam sexual assault Finding support for sexual assault If you've experienced sexual assault or were forced into any sexual activity, you should seek care from a trained healthcare professional. Organizations like the Rape, Abuse & Incest National Network (RAINN) offer support for survivors of rape or sexual assault. You can call RAINN's 24/7 national sexual assault hotline at 800-656-4673 for anonymous, confidential help. Endometrial or cervical polyps Polyps are small tissue growths that can occur in multiple places, including the cervix and uterus. Most polyps are benign, or noncancerous. Cervical polyps can cause: light bleeding after sex light bleeding between periods unusual discharge A doctor can easily see cervical polyps during a routine pelvic exam. You generally don't need treatment for cervical polyps unless you have symptoms that are bothering you. Treatment, if you need it, usually involves removing them. Doctors typically need imaging tests like ultrasounds to see endometrial polyps. They're often benign, but about 3% become cancerous. Having gone through menopause increases the risk of cancer from endometrial polyps, so it's important to talk with a doctor if you experience any possible symptoms of them. Symptoms of endometrial polyps can include: irregular menstrual bleeding heavy periods vaginal bleeding after menopause infertility Some people may experience only light spotting from polyps, and others may experience no symptoms. Sexually transmitted infection Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, can cause spotting between periods or after sex. Other STI symptoms can include: painful or burning urination white, yellow, or green vaginal discharge itching of the vagina or anus pelvic pain Contact a doctor if you suspect you may have an STI. Many STIs can be treated with minimal complications when caught early. Pelvic inflammatory disease Abnormal bleeding between periods is a common symptom of pelvic inflammatory disease (PID). You can develop PID if bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries. Other PID symptoms can include: painful sex or urination pain in the lower or upper abdomen fever increased or foul-smelling vaginal discharge PID can be severe or life threatening if the infection passes to the blood. If you experience signs of an infection or symptoms of PID, it's best to get medical attention. Antibiotics can treat most bacterial infections that cause PID. Fibroids Uterine fibroids are growths on the uterus. In some cases, they can affect fertility, making it harder to get pregnant or maintain a pregnancy. In addition to spotting between periods, they can cause: heavy or longer periods pelvic pain lower back pain painful intercourse urinary problems Some people with uterine fibroids don't experience any symptoms. This can depend on the location and size of the fibroids. If you have symptoms, a doctor may recommend treatment to shrink or remove uterine fibroids. Endometriosis Endometriosis is when endometrium-like tissue grows outside the uterus in areas like the: ovaries abdomen bowel It can cause bleeding or spotting between periods and other symptoms, such as: pelvic pain and cramping painful or heavy periods painful intercourse infertility painful urination or bowel movements diarrhea, constipation, bloating, or nausea fatigue About 1 in every 10 people of reproductive age with a uterus is believed to have endometriosis. However, endometriosis can be difficult to diagnose. For some people, it can only be definitively diagnosed through laparoscopic surgery. Polycystic ovary syndrome Irregular bleeding between periods can also happen due to polycystic ovary syndrome (PCOS). This condition occurs when the ovaries or adrenal glands produce high amounts of androgens, hormones that help regulate sex characteristics in the body. This can affect menstrual period regularity and also make it harder to get pregnant. PCOS typically occurs during childbearing years. Other PCOS symptoms can include: irregular menstrual periods pelvic pain weight gain excessive hair growth infertility acne Medications that commonly treat PCOS include: Hormonal birth control: Birth control may be available in a pill, patch, vaginal ring, or hormonal intrauterine device (IUD) to help balance your hormone production. Insulin medication: Metformin is a prescription drug commonly used to improve insulin levels in people with type 2 diabetes. It may also help regulate the menstrual cycle. Fertility medication: Prescription fertility drugs, such as clomiphene (Clomid), cause the pituitary gland to produce more follicle-stimulating hormone (FSH). Stress High stress can cause changes in your body, including fluctuations in the menstrual cycle. Some people may experience vaginal spotting from high levels of physical or emotional stress. Stress can result from: work or school relationships life changes economic, political, or social factors If you're experiencing high levels of stress, you may be able to take steps to manage it, like setting boundaries or practicing mindfulness. This may help stop your spotting. Medications Certain medications can cause vaginal bleeding between periods. These include: blood thinners thyroid medications hormonal drugs A doctor may take you off these drugs or recommend alternatives if you experience abnormal vaginal bleeding. Thyroid problems Having an underactive thyroid (hypothyroidism) can cause spotting after your period ends. Hypothyroidism means your thyroid does not produce enough thyroid hormones to regulate many of the body's processes, including menstruation. These processes can slow down. Other symptoms of hypothyroidism can include: fatigue weight gain constipation dry skin sensitivity to cold thinning hair muscle aches or weakness joint pain or stiffness high cholesterol Doctors may treat this condition with hormone pills, such as levothyroxine, if necessary. Is it spotting or your period? Spotting is different from the bleeding you experience during your period. Typically, spotting: is lighter in flow is pink, reddish, or brown doesn't last longer than 1 or 2 days Bleeding due to your menstrual period: is usually heavy enough to require a pad or tampon lasts 4 to 7 days produces a total blood loss of about 30 to 72 milliliters (mL) occurs every 21 to 35 days Should I take a pregnancy test if I'm spotting between periods? If you're of reproductive age and think you might be pregnant, you can take an at-home test. Pregnancy tests measure the amount of human chorionic gonadotropin (hCG) in your urine. This hormone rises rapidly when you're pregnant. If your test is positive, make an appointment with an OB-GYN (obstetrician-gynecologist) to confirm the results. If your test is negative but your period is more than a week late, it's still best to talk with a doctor. They can order tests to determine if an underlying condition is responsible for your missed period. Should I talk with a doctor if I have spotting between periods? If you have unexplained spotting between periods, it's best to talk with your doctor. It can sometimes be an indicator of an underlying health condition. It can help to record when your spotting occurs and any other symptoms you experience so that you can share the information with a doctor. Consider getting urgent medical care if you experience any of the following symptoms in addition to spotting: fever dizziness easy bruising abdominal pain heavy bleeding pelvic pain You should also talk with a doctor if you've already been through menopause and experience spotting. To determine what's causing your symptoms, a doctor may: perform a pelvic exam order blood tests recommend imaging tests How can I stop spotting between periods? Treatment depends on what is causing the spotting. For instance, if you have spotting due to a hormonal imbalance, doctors may recommend hormone medications. If a bacterial infection is to blame, a doctor may recommend antibiotics to clear the infection. A doctor can help determine the best approach to help you manage spotting. The bottom line A variety of factors can cause spotting before your period. Some require prompt medical treatment, while others are harmless. Although common, any vaginal bleeding that happens outside of your period may indicate pregnancy or a medical condition. You should talk with a doctor if you experience spotting, especially if you have already gone through menopause.