Spotting before your period can happen for many reasons. Most, like mild hormonal fluctuations and early pregnancy, are usually harmless. However, spotting sometimes occurs due to infection, fibroids, or thyroid problems, requiring treatment.
This article explores some potential causes of spotting and when to contact a healthcare provider.
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What Is Spotting?
Spotting is when you have light bleeding, not due to a regular period. It’s not uncommon to have some spotting a day before your period starts. Spotting that is more brown than red usually indicates older blood that has taken longer to leave your body.
What Causes Spotting Before Periods?
Abnormal uterine bleeding, including spotting, is most common in those who have just started to menstruate and those who are nearing menopause. It’s typically linked to a hormonal imbalance, but there are several other reasons you might be spotting.
Implantation Bleeding
Spotting can happen when a fertilized egg implants in the lining of the uterus. This generally occurs about one to two weeks after fertilization. This is usually before you know you are pregnant.
Birth Control
Spotting between periods is a fairly common side effect of hormonal contraceptives. This includes:
It’s most commonly associated with low-dose and ultra-low-dose pills, implants, and IUDs. If you have an IUD, spotting tends to improve in two to six months.
Ovulation
You ovulate about 12 to 14 days before a new menstrual cycle starts. about the midpoint between periods. Hormones associated with ovulation can cause spotting, though research suggests that ovulation bleeding is not common.
Pregnancy
Light bleeding or spotting in the first trimester is common, affecting about 15 to 25 in 100 pregnancies. Due to an increase in blood vessels, the cervix may bleed more easily, particularly after intercourse or a pelvic exam.
Other problems that can cause bleeding in pregnancy include:
- Ectopic pregnancy (when the fertilized egg implants somewhere other than the uterus, usually the fallopian tubes)
- Infection
- Placenta problems
- Pregnancy loss
- Preterm labor
Perimenopause
Changing hormone levels during perimenopause (the years preceding menopause, when the menstrual cycle permanently stops) can lead to abnormal bleeding patterns, including spotting between periods. More than 90% of women have at least one episode of abnormal bleeding during this transition.
Trauma
A recent surgery can cause some trauma to the uterus that leads to spotting. Injury can occur for a variety of other reasons, including intercourse, infection, and inflammation of the cervix.
Sexually Transmitted Infections (STIs)
Unusual vaginal bleeding is one potential symptom of some STIs. Other signs can include pain when you pee and genital itching, though STIs often have no symptoms.
Stress
Research suggests a link between stress and menstrual irregularities. Stress affects cortisol and other hormone levels, possibly contributing to spotting between periods.
Medication
Certain medications can affect your period. In addition to hormonal contraceptives, other types of hormone therapies, including those you might take for menopause symptoms, can cause breakthrough bleeding. In addition, drugs such as blood thinners (anticoagulants) and aspirin can cause heavier bleeding.
Uterine or Cervical Polyps
Uterine and cervical polyps are abnormal growths that form on the uterus or cervix. While there are often no symptoms, they can cause abnormal bleeding, including heavier periods and spotting between periods.
Pelvic Inflammatory Disease (PID)
PID is an acute or chronic infection of the upper genital tract. It has many causes, including STIs. One possible symptom is abnormal vaginal bleeding, including spotting between periods. Symptoms are often mild, and delayed diagnosis is common.
Fibroids
Uterine fibroids are benign uterine tumors that affect 20% to 40% of women during their reproductive years. Symptoms can include abnormal uterine bleeding, pelvic pressure, and urinary incontinence.
Endometriosis
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. The most common symptom is pain, but it can also cause bleeding or spotting between periods.
Polycystic Ovary Syndrome (PCOS)
PCOS is a condition in which cysts grow on the ovaries. This disrupts the balance of hormones, leading to spotting.
Thyroid Problems
The thyroid gland helps control your menstrual cycle. Problems with the thyroid can produce symptoms similar to those of menopause. It can affect fertility and make your period lighter, heavier, or irregular.
Cancer
About 90% of women with endometrial cancer experience spotting between periods. Bloody vaginal discharge can also be a sign of cervical or vaginal cancer.
Spotting or Your Period: How to Tell the Difference
Spotting is when you have light bleeding, which may be red, pink, or brown, at a time other than your regular period. There are generally no other symptoms, and it’s light enough that you may not need protection for your clothing.
A period is when the uterus sheds its lining, so it’s a heavier flow that requires a pad or other protection. You might have different symptoms, such as bloating and cramping. The menstrual cycle has a somewhat predictable pattern, with a flow that lasts around five days. A period can be shorter or longer and still be normal. Everyone’s cycle differs.
How to Manage Spotting Before Your Period
A little spotting is often harmless, though it can be annoying. Depending on how much you’re spotting and what you need to do, you may want to use protection such as panty liners, pads, or period underwear.
Track spotting as you track your period. Note how often, how long, how heavy, and what it looks like. This may prove helpful when you visit a healthcare provider.
How Spotting Before Your Period Is Treated
Treatment will depend on the cause and may include changing contraceptives. If spotting is due to a condition such as endometriosis, fibroids, or STI, treatment will focus on that condition.
Should I Take a Pregnancy Test?
If you think you may be pregnant, there’s no harm in taking a test. But taking it before you miss your period can result in a false negative.
Pregnancy tests measure a hormone called human chorionic gonadotropin (HCG) in your urine, which you only produce when you’re pregnant. Most pregnancy tests can detect HCG about 12–15 days after ovulation. A positive result means you’re pregnant, but a negative result may mean that you haven’t started producing detectable levels of HCG yet.
When to Contact a Healthcare Provider
See a healthcare provider if you are experiencing bleeding:
- After having sex
- After menopause
- Along with other symptoms
- Between periods
Your provider will likely perform a physical exam and review your health history and any other symptoms you may have. Tests that may help determine the cause include:
Summary
Spotting between periods can take you by surprise. But it’s usually harmless. It may mean that you’re ovulating, pregnant, or need to change contraceptives. But spotting can also be a symptom of a health problem. Treating conditions such as endometriosis, thyroid problems, and infection can help put an end to spotting.
If you have questions about spotting or have other symptoms, it’s worth seeing a obstetrician-gynecologist (ob-gyn) or other healthcare provider for diagnosis.
