Why Am I Spotting

Thyroid conditions are more common directly following pregnancy or menopause.

What Does It Mean If You Have Spotting Instead of Your Period?

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You may skip a period or have spotting instead of a period due to stress or certain birth control methods. But it may also occur if you have an underlying health condition.

Menstrual periods are the result of a complicated balancing act between the hormones estrogen and progesterone.

There are a variety of things that can interrupt this balance, leading to skipped periods or spotting instead of a period. Spotting is lighter bleeding than a normal flow. It generally doesn’t require much protection from a pad or tampon.

Many causes of spotting are no reason for concern and may even be normal depending on your age or other factors, such as pregnancy. Other causes might signal it’s time to see your doctor for treatment of an underlying condition.

Here are 11 possible causes for spotting instead of your period.

Spotting at the time of your period, which is around 10 to 14 days after ovulation, may be caused by implantation in early pregnancy. When implantation occurs, the fertilized egg burrows deeper into the uterine lining, causing the spotting.

Other early pregnancy symptoms:

• swollen, tender breasts
• nausea
• vomiting
• frequent urination
• fatigue

If you suspect you may be pregnant, try taking a home pregnancy test. You may get a positive result as early as four or five days before an expected period. To avoid a false negative, it’s wise to wait until you’ve missed your period.

Chlamydia and gonorrhea are STIs that may cause spotting at any time throughout your cycle. These infections can be acquired through vaginal, oral, or anal sex. They may start with few or no symptoms or just mild signs.

As the infection progresses, spotting can happen along with other symptoms, like:

• pain during sex
• burning or pain during urination
• changes in vaginal discharge
• foul-smelling green or yellow discharge
• nausea
• fever
• anal itching or discharge, soreness, or bleeding

These STIs can be treated with antibiotics. It’s important that any sexual partners get treatment as well to prevent reinfection.

PID may result when an STI goes untreated for a long period of time. It usually means that the infection has traveled from the vagina to the reproductive organs. Like other infections, it may cause irregular bleeding and spotting at the time of your expected period, and otherwise.

Other symptoms include:

• pain in the pelvis or abdomen
• pain with urination
• heavy and/or foul-smelling vaginal discharge
• bleeding after sexual intercourse
• bleeding between periods
• fever and chills

Treatment includes antibiotics, treatment of sexual partners, and abstinence until the infection has cleared.

Girls just starting their periods may have irregular cycles as their bodies adjust to menstruation. This typically occurs between the ages of 10 and 15. Periods during this time can be:

• close together
• farther apart
• heavy
• very light (spotting)

Over time, hormones adjust and the flow should regulate and become more predictable.

The same goes with older women. As you approach menopause, hormone levels become unpredictable. During perimenopause, periods may be heavier or lighter, longer or shorter, and more spaced out or closer together. This unpredictability may continue until periods stop altogether.

Very low body weight can impact your hormones. When the hormones are interrupted, it may stop ovulation. This may lead to a condition called amenorrhea, or one or more missed menstrual periods. Other symptoms beyond spotting include:

• hair loss
• headaches
• acne
• a milky discharge from the nipples

Excessive exercise is linked to amenorrhea as well. Too much movement can lead to what’s known as the “female athlete triad.” This refers to disordered eating, amenorrhea, and osteoporosis. Without treatment, this may lead to heart issues, weak bones, and infertility.

Ovulation is the release of a mature egg into the fallopian tube. This event typically happens around day 14 of a 28-day menstrual cycle.

Once ovulation occurs, the body produces more progesterone to prepare for possible pregnancy. If a fertilized egg doesn’t implant into the uterus, hormone levels drop and signal the body to have a period.

Whenever normal ovulation is interrupted, the menstrual cycle may become irregular. Occasional anovulation is caused by weight, age, and stress.

Long-term anovulation may be a sign of conditions, such as polycystic ovarian syndrome (PCOS). You can still have periods without ovulation. They may look like spotting or a very light flow.

Irregular periods is a symptom of PCOS. This condition is caused by hormones called androgens that can interrupt ovulation.

Instead of developing and releasing one egg each cycle, the ovaries may develop multiple follicles but not release them. When this happens, you may experience light breakthrough bleeding or spotting instead of a true period.

• acne
• excess body or facial hair
• male pattern baldness
• weight gain
• pelvic pain
• infertility

Treatment for PCOS includes:

• birth control to regulate your periods
• diet
• exercise

An estimated 1 in 8 women may develop a thyroid condition at some point. One of the main symptoms is irregular menstrual cycles. When too much or too little thyroid hormone is released in the body, you may spot or have only a light period. Periods can also become heavy or stop.

Other symptoms include:

• fatigue
• restlessness
• weight gain or loss
• infertility
• issues during pregnancy

Thyroid conditions are more common directly following pregnancy or menopause.

Light periods or spotting instead of a period is also a sign of excess stress. This stress can be physical, meaning: too much exercise, strict dieting, or severe illness. It can also be emotional, which may be due to big life events, such as divorce, a death in the family, or an important work deadline.

Periods may become more painful or even stop entirely until the cause is addressed.

If you think stress is impacting your cycle, consider trying to find more ways to relax. Engaging in regular activity may help, such as:

• yoga
• jogging
• walking
• meditation
• breathing exercises

Hormones in different birth control methods, like the pill, patch, or shot, may cause spotting instead of a normal period.

Estrogen helps to stabilize the lining in the uterus. It may shed irregularly if you’re on a method that’s low in this hormone. This symptom is more common in the months after you first start using it.

The following birth control methods can reduce periods and lead to spotting:

Some methods are meant to be used continuously to help skip periods. You may also experience spotting with these methods. To get a full period, take off three to five days between packs of pills or rings.

In rare cases, you may see spotting instead of your period due to underlying cervical or uterine cancers.

Risk factors include:

• age
• family history of ovarian or cervical cancer
• use of estrogen replacement therapy
• carrying BRCA1 or BRCA2 gene mutations
• early start to menstruation
• late start to menopause

Early cancer may not cause any symptoms. As the cancer progresses, you may experience:

• pain or discomfort in the pelvis
• constipation or other bowel changes
• weight loss
• frequent urination
• swelling or bloating in the abdomen
• a feeling of fullness when eating

So, how can you tell if you’re spotting versus having your normal period? There are some key differences in the amount of blood you’ll see, the color, and other characteristics.

Spotting

Period

Seeing spotting instead of a period one month may not be a reason for concern. For example, if you’re very stressed one month or perhaps skip your period because you’re nearing menopause, your regular flow may return the following month with no treatment needed.

If your spotting is being caused by medical conditions, such as PCOS, thyroid issues, or STIs, you may experience other symptoms that prompt you to call your doctor. The same goes with possible pregnancy. Pay attention to the other symptoms you’re experiencing along with spotting and make an appointment.

Always call your doctor if your spotting is accompanied by:

• pain
• fever or chills
• foul-smelling discharge
• other signs of infection

Experiencing spotting in place of your period may be normal from time to time. There are a variety of situations that can alter the hormonal balance in the body and lead to a disrupted cycle.

Consider tracking your periods on paper or in a tracking app, like Clue. Record things like the number of days you see bleeding or spotting, the color of the blood, and the flow to watch for patterns.

If you experience other symptoms that concern you, don’t hesitate to contact your doctor.

Last medically reviewed on April 9, 2019

Is It Spotting or My Period? Signs, Differences, and Causes

Elizabeth Pratt is a medical journalist based in Australia. She has a Master’s degree in Health Communication and a Bachelor’s degree in journalism.

Published on January 07, 2022

Chioma Ndubisi, MD, is a board-certified OB/GYN who specializes in sexual and reproductive health in New York, New York.

Spotting is light vaginal bleeding that occurs outside of a regular menstrual period. It is different than a normal menstrual period in several ways. Spotting is often harmless but can also be an indication of a problem like a sexually transmitted infection (STI) or uterine fibroids (growths in the uterus).

This article will discuss the symptoms of spotting and menstrual periods and the causes of spotting.

Verywell / Jessica Olah

How Do You Know If It’s Spotting or Your Period?

Although spotting and periods both appear as bleeding from the vagina, there are some key differences:

• Spotting is lighter and may not require the use of sanitary protection.
• Periods may also be accompanied by other symptoms that distinguish the two.

Symptoms of Normal Periods

The regular shedding of the lining of the uterus is referred to as menstruation . It may also be called a menstrual period, menstrual cycle, or menses. During this time, blood flows from the vagina. In people with a uterus and ovaries, it usually occurs monthly from puberty until menopause (marking the end of menstruation, when periods have stopped for 12 straight months). Menstruation normally stops during pregnancy.

In addition to vaginal bleeding, many people experience other symptoms while menstruating. These include:

• Cramping in the lower abdomen
• Cramping in the lower back
• Moodiness
• Cravings
• Difficulty with sleep
• Bloating
• Tender breasts
• Acne

Conditions Causing Symptoms of Spotting

Any bleeding or spotting that occurs outside the usual time of menstruation is considered abnormal uterine or vaginal bleeding. But this doesn’t always mean it is something to worry about.

Spotting is light bleeding that comes from the vagina. It may appear as a few spots of blood on your underwear. This will not require the use of sanitary protection like a pad, panty liner, or tampon.

Spotting or abnormal bleeding can be due to several causes, including polycystic ovary syndrome (PCOS), pregnancy, ectopic pregnancy, ovulation, birth control, STIs, cancer, fibroids, and perimenopause.

What Causes Spotting

Spotting can be normal and nothing to worry about, or it can be an indication of a problem that warrants attention by a healthcare professional.

Pregnancy

During the first trimester (first 12 weeks of pregnancy), 15–25 out of every 100 pregnancies will experience bleeding. One to two weeks after a fertilized egg implants into the lining of the uterus, some spotting or light bleeding may occur.

During pregnancy, it is also possible to experience spotting or light bleeding following sexual intercourse, a Pap test (a swab of the cervix to check for abnormal cells), or a pelvic exam (internal and external examination of the organs in the pelvis).

Ectopic Pregnancy

An ectopic pregnancy happens when a fertilized egg grows outside the uterus, most commonly in the fallopian tube. This is a nonviable pregnancy that must be treated to prevent potentially severe (even fatal) complications.

An ectopic pregnancy may cause pregnancy symptoms like a missed period or tender breasts. It may also cause:

• Abnormal bleeding from the vagina
• Mild cramping to one side of the pelvis
• Mild abdominal pain
• Lower back pain

Polycystic Ovary Syndrome

Polycystic ovary syndrome is a hormonal disorder that can cause irregular menstrual periods and problems with fertility. People with PCOS may experience abnormal vaginal bleeding like spotting due to a lack of ovulation.

Birth Control Pills

Birth control pills and other forms of hormonal contraception can cause side effects. Among these side effects is spotting, also referred to as breakthrough bleeding. This most commonly happens in the first few months of starting a new form of hormonal birth control. Spotting may stop after this time.

Implantation Bleeding

Following fertilization, an embryo attaches to the wall of the uterus. During this time, some blood vessels can break down, and this can cause spotting.

This is known as implantation bleeding. The spotting may be brownish in color and is not heavy. It may not occur in every pregnancy.

Uterine Fibroids or Polyps

Uterine fibroids are growths of the uterus. They are not cancerous and may not cause symptoms.

If symptoms do occur, they may include:

• Abnormal vaginal bleeding like spotting
• Lower back pain that persists
• Pelvic pain
• Pain during sex
• Urinary issues

Uterine polyps are growths in the lining of the uterus that are usually noncancerous (although they can also be precancerous or cancerous). They may also cause spotting.

Ovulation Bleeding

Spotting can occur any time during the menstrual cycle. Ovulation marks the middle of the cycle, when the ovary releases an egg. During ovulation, some light spotting may occur. This is not a cause for concern.

Breastfeeding

People who exclusively breastfeed a child may not have a period for months or even a year after childbirth. If a person partially breastfeeds, their periods may return as soon as three weeks following birth.

When breastfeeding time is reduced and periods begin to return, this may start as light spotting.

Injuries

Injuries in the genital area can cause spotting. Injuries or trauma to the genital area include:

• Cuts
• Bruises
• Lacerations

Straddle injuries can also cause spotting. These injuries occur when a person falls onto an object, like a fence, bike, or playground equipment, and strikes the object with their groin area.

Miscarriage

The most common indication of a miscarriage (loss of a pregnancy in the first 20 weeks of gestation) is bleeding from the vagina. Bleeding can range from a brown discharge and light spotting to heavy bleeding and clots. This can come and go.

Perimenopause

Perimenopause can occur from ages 45 to 55. During this time, the ovaries become smaller and make less estrogen. It is normal to have spotting during this time.

Cancer

Roughly 90% of people who have endometrial cancer (cancer of the uterine lining) have some form of abnormal vaginal bleeding. This can include spotting, changes to periods, and bleeding after menopause.

STIs

Not all STIs have symptoms, but STIs like chlamydia can cause bleeding between periods.

Other symptoms that may accompany spotting with STIs include:

• Unusual genital discharge
• Pain during sex
• Pain in the lower abdomen
• Bumps and sore on the genitals
• Pain with urination

Summary

Spotting is light bleeding that may appear as spots of blood in the underwear. Unlike menstrual bleeding, it typically does not require the use of a pad or tampon. Spotting can have many causes, including ovulation, early pregnancy, infections, or injuries to the genital area. If you are concerned about spotting, speak with your doctor.

A Word From Verywell

Knowing what is normal for your menstrual flow allows you to identify when you are having abnormal vaginal bleeding. Whenever you have a concerning symptom, call your healthcare professional for advice. They have heard such questions often and will be able to ensure you get appropriate diagnosis and treatment.

Frequently Asked Questions

How does spotting look in early pregnancy?

During early pregnancy, bleeding from the vagina can occur one to two weeks following fertilization. This may be light bleeding or spotting. The blood spots can be brown, pink, or red.

Does spotting mean you’re pregnant?

Spotting can be an indication of early pregnancy and implantation bleeding. But it can also be a sign of miscarriage, infection, and several other causes.

Can you take a pregnancy test while spotting?

Implantation bleeding can occur at the same time of an expected period. Implantation bleeding is lighter spotting compared with heavier bleeding from a normal menstrual period. If the spotting is accompanied by other symptoms that could be indicative of pregnancy like nausea, fatigue, and frequent urination, taking a pregnancy test may be a good idea.

How much bleeding is considered spotting?

Spotting differs from standard menstrual bleeding in that it is very light. It often appears as just a few spots on your underwear and doesn’t usually require the use of sanitary protection like a pad, panty liner, or tampon.

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. University of Michigan Health. Abnormal vaginal bleeding.
2. Cleveland Clinic. Normal menstruation.
3. MedlinePlus. Vaginal bleeding in pregnancy.
4. American College of Obstetricians and Gynecologists. Bleeding during pregnancy.
5. American College of Obstetricians and Gynecologists. Ectopic pregnancy.
6. UCLA Health. Polycystic ovary syndrome (PCOS).
7. Planned Parenthood. What are the side effects of the birth control pill?
8. Memorial Care. What color is implantation bleeding?
9. Von Voigtlander Women’s Hospital. Uterine fibroids & abnormal bleeding.
10. Cleveland Clinic. Uterine polyps.
11. Health Direct. Periods while breastfeeding.
12. Health Direct. Vaginal bleeding.
13. Seattle Children’s. Genital injury – female.
14. National Health Service. Symptoms – miscarriage.
15. American College of Obstetricians and Gynecologists. Perimenopausal bleeding and bleeding after menopause.
16. American Cancer Society. Signs and symptoms of endometrial cancer.
17. Pregnancy Birth and Baby. STIs and pregnancy.

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