Spotting Vs. Period? Causes, Diagnosis, and Treatment

Have you ever experienced bleeding between periods? Known as spotting, this is quite a common phenomenon for some women. Is spotting something to worry about, or is it normal? Why does it happen? Is it different from the light bleeding that occurs before periods? Read on as we answer all your questions about spotting.

What is spotting?

Spotting is defined as very light vaginal bleeding or brown discharge that happens outside of your menstrual periods. Spotting is much lighter than menstrual bleeding and involves a minimal amount of blood. You may notice this blood on your panty or toilet paper after you use the restroom. You may have to use a panty liner, and sometimes it is so light that it won’t even soak through your panty liner. The color of the blood may be lighter than that during your periods.

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What is the difference between menstrual bleeding and spotting?

There are some critical differences between menstrual bleeding and spotting, the biggest being the amount of blood. Here are some other differences between menstrual bleeding and spotting.

Menstrual bleeding

Menstrual bleeding, also known as a menstrual period, occurs every 28 days on an average and lasts between 2 to 7 days. During each menstrual cycle, the lining of the uterus becomes thick in preparation for pregnancy. When that does not happen, the uterus sheds its lining, causing menstrual bleeding.

These are the main characteristics of menstrual bleeding –

  • Regularity – Most women experience their periods at the same time every month. The length of time between periods can be different for different women and ranges from 21 to 35 days.
  • Bleeding pattern – Women usually experience light bleeding at the beginning of the period, heavier bleeding towards the middle, and light bleeding again towards the end of the period.
  • No bleeding days – Women experience days when there is no bleeding at all during their menstrual cycles.
  • Other symptoms – During the days leading up to the period, women may experience premenstrual syndrome, which is caused by hormonal changes. The symptoms of PMS include headaches and breast tenderness. Some women also feel cramping during their periods.
  • Blood color – Menstrual blood is usually red, but it can be brown during the beginning and end of the period. You may also notice clots or a string of blood during the period.

Spotting

Spotting is vaginal bleeding that you experience when you’re not on your period. While spotting is mostly not a cause for concern, in some cases, it can indicate a more serious problem.

These are some of the main features of spotting –

  • Spotting is irregular and does not follow a pattern. You may be spotting one day and show no spotting the next day.
  • Some women may experience spotting around the time they ovulate. This spotting occurs due to hormonal changes.
  • Spotting is different from menstrual blood and is usually brown. Some women also find that the blood from spotting is lighter and different in texture.
  • Hormonal birth control methods like pills can also cause spotting sometimes.
  • Injuries can lead to spotting, and this kind of spotting causes abdominal pain.

What causes spotting?

There can be several reasons for spotting. Some of these are harmless, while a few others can be symptoms of a severe problem.

1. Birth control methods

Some birth control measures can cause spotting. Some women may notice spotting when they first begin using birth control pills. Not taking birth control pills correctly, using them continuously, or skipping doses can cause spotting. Some women who use an intrauterine device for birth control also report spotting.

2. Implantation bleeding

Implantation bleeding occurs in the early weeks of pregnancy when the fertilized egg attaches itself to the wall of the uterus. Women sometimes mistake this light bleeding for their menstrual period and do not realize that they are pregnant. Implantation bleeding is light pink or dark brown and does not last very long.

3. Ovulation

Some women also experience spotting around the time of ovulation, which is when ovaries release an egg. Ovulation bleeding usually occurs in the middle of the menstrual cycle and is caused by changes in estrogen and progesterone levels.

Ovulation spotting is much lighter than a regular period and sometimes accompanied by light cramping.

4. Pregnancy

Spotting in early pregnancy is common, and in most cases, does not indicate a serious problem. Around 15 to 25 percent of women experience light bleeding during early pregnancy (1).

You may experience spotting when the fertilized egg implants in the uterine lining. Your cervix may bleed more easily when you are pregnant as more blood vessels are developing in this area. This bleeding is light and can be red, pink, or brown.

If you experience heavy bleeding along with pelvic pain, contact your doctor as it may be a sign of ectopic pregnancy or miscarriage.

5. Uterine fibroids or polyps

Polyps and fibroids are noncancerous growth inside the uterus. In addition to spotting, these growths can also cause symptoms like pain, irregular periods, fertility problems, and painful intercourse.

6. Cervical polyps

Cervical polyps are small benign growths that form either outside the cervix or inside the cervical canal. Cervical polyps can cause light spotting between your menstrual periods. Other symptoms include vaginal bleeding after intercourse, white or yellow mucous discharge from the vagina and bleeding after menopause.

7. Perimenopause

Perimenopause is the time when your body makes the transition to menopause. During perimenopause, your hormones do not follow a regular pattern, resulting in irregular bleeding or spotting (2). During this time, your periods may be longer and heavier or shorter and lighter than usual.

8. Breastfeeding

Many breastfeeding mothers are completely period-free for the first few months after they give birth. As your baby starts breastfeeding less often, around three feeds a day, you may notice some spotting. After giving birth, a woman’s hormones are constantly fluctuating and attempting to get back to normal. Spotting during this time is quite common.

9. Injuries

An injury to the cervix, vagina, or uterus can cause spotting. Sexual assault, rough sex, a pelvic exam, and even a tampon can cause injury and spotting. Seek the help of a trained healthcare provider in case of sexual assault.

10. Sexually transmitted infections

Some sexually transmitted infections (STI) like gonorrhea or chlamydia, can cause abnormal vaginal bleeding or spotting. Other symptoms of STI include pain or burning during urination, unusual discharge from the vagina, itching in the vagina or anus, and pelvic pain.

11. Pelvic inflammatory disease

Pelvic inflammatory disease is an inflammation of the reproductive organs spread by sexual contact. It can damage ovaries, uterus, fallopian tubes, and other parts of your reproductive system. PID can cause spotting and cramping throughout the month. It can also create a dull pain, abnormal discharge, chills and high fever, and pain during intercourse.

12. Endometriosis

Endometriosis is a condition where the tissue that makes up the uterine wall grows outside the uterus. This condition can cause painful periods, pelvic pain, and cramping and can also cause bleeding and spotting between periods.

13. Hypothyroidism

People with an underactive thyroid may experience spotting between periods and heavy and irregular periods. Hypothyroidism symptoms include weight gain, fatigue, constipation, dry skin, joint pain, and puffy face.

14. Polycystic ovary syndrome

PCOS is a hormonal problem that affects women of childbearing age. Women with PCOS do not ovulate. Irregular bleeding between periods can sometimes be a sign of PCOS.

15. Stress

Stress and anxiety can have a significant impact on your menstrual cycle. It can delay menstruation, causes spotting between periods, or even stop your periods altogether.

16. Cancer

Spotting in postmenopausal women can sometimes be a sign of cancer. Spotting is the primary symptom of uterine cancer and can also indicate a fallopian tube or cervical cancer.

17. Other medical conditions

Diabetes, liver disease, kidney disease, and bleeding disorders can sometimes cause spotting between periods.

When should you see a doctor for spotting?

Whether vaginal bleeding or spotting between periods is normal or not depends on your age and circumstances. In general, you must consult your doctor if you ever experience unexpected vaginal spotting.

  • If you are pregnant and you notice vaginal bleeding, contact your doctor immediately.
  • If you are postmenopausal and are not taking any hormonal therapy, contact your doctor if you see vaginal spotting.
  • Girls who do not have any signs of puberty or are younger than eight years should have any vaginal bleeding or spotting investigated.
  • Visit your doctor if your spotting is accompanied by other symptoms like fever, dizziness, abdominal pain, or pelvic pain.
  • Consult your doctor if your spotting lasts for more than a few days.

These situations are normal, but you can consult your doctor if you are concerned.

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  • Young girls who have just begun having periods may experience irregular cycles during the first few months. They may also have light spotting for a few days before menstruating.
  • Women who use hormonal birth control pills may experience occasional spotting during the first few months.
  • Perimenopausal women may experience irregular periods and spotting between periods.

Diagnosis and treatment

When you visit your OB/GYN, he/she will ask you about your symptoms and do a physical exam (including a pelvic exam), to identify the cause of spotting. You will also be asked to get one or more of the following tests –

  • Blood work
  • Ultrasound
  • Pap smear
  • Pregnancy test

Once your doctor can identify what is causing the problem, he will treat you accordingly. He may prescribe antibiotics or antifungal medication to treat any infections. Birth control pills or other hormones can help to regulate your menstrual cycle. If you have any growth in your cervix or uterus, your doctor may perform a procedure to remove them.

Final thoughts

Spotting is light bleeding from the vagina that is not due to the menstrual period. Spotting is different from the menstrual period as it is not regular and does not follow a pattern. There can be several reasons women experience spotting, some harmless, and others, which are symptoms of a serious problem. You must consult your OB/GYN if you ever experience unexpected vaginal spotting. Once your doctor can identify what is causing the problem, he will treat you accordingly.

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