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  • Samantha Ellsworth

Why Am I Spotting?

Fact-Checked by: Dr. Tara Scott, OB-GYN

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Sometimes, spotting can make a surprise appearance right in the middle of your menstrual cycle. With one drop here or two drops there, spotting between periods might leave you wondering if your period is back again—but should you be concerned?


Spotting involves light vaginal bleeding that happens between your periods. A few days after your period ends or in the middle of your cycle, you might notice spotting on toilet paper after using the restroom or a few spots of blood in your underwear. Instead of using a pad or tampon, you can typically use a panty liner for protection against spotting.


“Every woman’s cycle varies, and you may occasionally experience spotting between periods,” according to Christine C. Greeves, MD. “Several things can cause spotting, including stress, an infection, changing your birth control medication, and hormone imbalance.”


From why spotting happens to the differences between periods and spotting, here’s everything you need to know about spotting to understand what’s normal and what might be a cause for concern.


Spotting vs. Bleeding: What’s The Difference?


Sometimes, figuring out whether you’re bleeding (i.e., during your period) or spotting can get kind of confusing. While menstrual bleeding is associated with the shedding of the endometrium at the end of the menstrual cycle, spotting can be a bit more ambiguous.


“Spotting is the vaginal bleeding after your menstrual period before your next period,” according to Jeffrey M. Rothschild, MD, MPH. Researchers and healthcare providers describe spotting as bleeding that doesn’t require sanitary protection, meaning you don’t need to wear a pad or tampon. Spotting can happen at any point during your menstrual cycle, from a few days before your period to between periods.


Meanwhile, non-menstrual bleeding (or heavy spotting) is heavier bleeding that doesn't seem to be linked to your period and that requires sanitary protection.



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Where Does Spotting Come From?


Spotting can come from your upper reproductive tract (your uterus) or lower reproductive trait (your cervix or vagina).


Contrary to popular belief, spotting is different from menstrual bleeding, which involves the shedding of your uterine lining. While heavier spotting often comes from the uterus, lighter spotting can come from your upper or lower tract.


Here are some common reasons for spotting...


Birth Control


Spotting is a common side effect of birth control, and spotting between periods is especially common during the first few months of starting a new type of hormonal contraception. Spotting on birth control can also happen after your period, which can make it seem like you have an extra-long period compared to your usual cycle.


If you’re currently taking combined oral contraceptives (the most common type of birth control pill), you might notice spotting that goes away after a few months. If spotting on birth control continues, talk to your doctor about switching to another pill with a different chemical formulation. Spotting might also happen if you miss a pill due to changes in your hormone levels.


With hormonal IUDs, spotting can be unpredictable. Spotting is also common with contraceptive implants, birth control injections, and mini-pills (progestin-only pills).


Pregnancy


Sometimes, spotting can be a symptom of early pregnancy. Approximately 1 in 4 people experiencing spotting during early pregnancy, usually between gestational weeks 5 and 8 (or about 1–4 weeks after you’d normally expect your period).


In general, spotting during early pregnancy isn’t a cause for concern, as research has shown that people who experience spotting aren’t more likely to have a miscarriage. With that said, heavier spotting or bleeding may be a concern. If you’re pregnant and bleeding, be sure to check in with your healthcare provider.

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Ovulation


Sometimes, spotting between periods can occur around the time of ovulation. Approximately 3% of women experience spotting related to ovulation, which can

happen anywhere between 11 days and 21 days after the first day of your most recent period.


While it’s unclear why some people experience ovulation spotting and others don’t, research suggests that it happens more often in those with higher hormone levels. Ovulation spotting is typically associated with a sharp drop in estradiol levels during ovulation, which can cause light bleeding toward the middle of your cycle.


Infection


Some types of sexually transmitted infections (STIs), such as chlamydia, can lead to spotting between periods. Other infections, including pelvic inflammatory disease and cervical infections, may also cause unexpected vaginal bleeding. Other common symptoms include painful urination, itching, and white, yellow, or green vaginal discharge.


If you suspect an STI, contact your doctor as soon as possible. Although dealing with an STI can feel scary, talking to your doctor early is key to treating your infection with minimal complications.


Endometriosis


Endometriosis happens when the tissue that normally lines the inside of your uterus grows outside of the uterus. Endometriosis commonly causes bleeding or spotting between periods, as well as other symptoms, including painful intercourse, pelvic cramping and pain, and fatigue.


Approximately 1 in 10 women in the United States has endometriosis, but many cases go undiagnosed. If you think you might have endometriosis, schedule an appointment with your OB/GYN to discuss your symptoms.


Stress


Stress—and the hormone imbalances that come with it—can lead to spotting between periods, and even late or skipped periods.


If you’re living with stress, finding healthy ways to manage your stress can make all the difference in your overall well-being, including the regularity of your cycles. Before thinking about ways to change your diet or start exercising, ask yourself, “how do I feel?”


Burnout, lack of sleep, and disregard for your own needs can disconnect you from yourself and lead to stress. If you’re experiencing a lot of stress, try meditating, preparing a relaxing bath, or taking some extra time for yourself to better understand your body’s needs.


Get To Know Your Cycle


It can be a little unnerving to experience spotting between periods—but more often than not, spotting isn’t a major cause for concern. If you’ve noticed consistent spotting over the past few months, consider keeping a menstrual diary to get to know cycles and bleeding patterns.


If you’re worried about spotting for any reason, don’t hesitate to schedule an appointment with your OB/GYN. “Even if the cause of the spotting turns out to be something minor, getting timely medical treatment and care will help you resolve this issue,” says Greeves.


Whether you’re keeping a written journal or tracking your cycle on an app, setting aside some quality time for self-care can

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give you peace of mind and help you feel more at ease. Above all else, remember that spotting is normal—and it’s nothing to be embarrassed about!