Spotting Before or After Period: Low and High-Risk Causes Not to Ignore

Spotting between periods can be a cause for concern for many women. In the majority of cases, there is nothing to worry about if you notice spotting before or after your period. In fact, light vaginal bleeding or spotting in the middle of the menstrual cycle can be normal for some women. For example, ovulation bleeding, implantation spotting, or even stress can cause pink or brown spots on your underwear before or after your period.

It’s important never to ignore spotting after your period has ended. Spotting between periods could also be a symptom of something more serious. Spotting before or after your period can be a sign of ovarian cysts, pelvic inflammatory disease, fibroids, or cancer. Also, if you have passed the menopause and you notice any irregular bleeding, then you should visit your doctor for a checkup.

Depending on the cause of the irregular bleeding that isn’t connected with your period you may also have other symptoms. Sometimes, spotting that happens between periods is accompanied by abdominal cramping, vaginal discharge that has an abnormal color, lower abdominal pain, and pelvic discomfort.

In this article, you will find out about the many reasons for spotting between periods. In some cases, home remedies can help to relieve some of the discomfort. You will also find out when you should see a doctor about abnormal vaginal bleeding.

Spotting Between Periods – What Does It Mean?

Spotting is light vaginal bleeding that occurs before your period begins or after your period has ended.

According to doctors from the Mayo Clinic, the menstrual cycle lasts an average length of 28 days. For some women, a normal menstrual cycle could be as short as 21 days or as long as 35 days. The menstrual cycle is counted from the first day of the period when menstruation starts. Menstrual bleeding can last between 2 and 7 days.¹

The medical name for spotting between periods is metrorrhagia. Doctors say that this refers to vaginal bleeding that happens between expected menstrual periods.²  This type of irregular bleeding can also be called intermenstrual bleeding. Dr. Louise Newson says that symptoms of bleeding between menstrual periods should be checked out by a doctor.³

Spotting vs. Bleeding – What’s the Difference?

There are three basic differences between spotting and bleeding. These are:

• The amount of flow
• Color of blood from the vagina
• Pattern of vaginal bleeding

According to Dr. Melissa Conrad Stöppler on MedicineNet, spotting is very light vaginal bleeding that happens before your period or after it. The amount of blood associated with spotting will look like spots on your underwear or pad and won’t be as much as period blood. This type of bleeding happens at irregular intervals between periods.⁴

Another difference between bleeding during your period and spotting that occurs after your period has ended is that menstrual blood is dark red. Dr. Conrad Stöppler says that vaginal spotting may look like pink, red, or brown rust-like spots. These are noticeable when you are not menstruating.⁴

The pattern of vaginal bleeding also helps to differentiate between spotting and menstruation. According to the American Journal of Epidemiology, bleeding at the start of the menstrual period starts as light bleeding and gradually becomes heavier. The blood flow increases in the first 3 days and then gradually becomes lighter.⁵

Spotting doesn’t usually follow a set pattern and can happen at any time when you are not menstruating.

Symptoms of Spotting or Bleeding

Because spotting is usually a symptom of another medical condition, there will often be other symptoms. Sometimes, identifying the other symptoms that occur with spotting can help to know the cause.

According to Dr. Melissa Conrad Stöppler, symptoms of spotting can include:⁴

• Abdominal pain or cramping
• Heavier than normal menstrual bleeding
• Irregular periods
• Burning sensation when urinating
• Vaginal discharge
• Signs of vaginal infection like swollen labia, redness, or itching

Bleeding during menstruation may also cause some of the symptoms of spotting like cramping and you might have irregular periods. According to the National Institute of Health, other signs of menstruation include:⁶

• Bloating
• Sore breasts
• Mood swings
• Headaches
• Fatigue

Causes of Spotting Between Periods

Let’s look at some of the common reasons why you might notice spotting between periods.

Ovulation spotting

Mid cycle spotting could be a sign that you are ovulating. Ovulation occurs about 10 to 14 days after the start of the menstrual cycle and can cause light bleeding (ovulation bleeding) about 2 weeks before your next period.

According to Dr. Andrew Kaunitz, who is a Professor of Obstetrics and Gynecology at the University of Florida, sudden changes in hormone levels around ovulation can cause vaginal spotting between periods. You may notice spotting between periods especially if you have an irregular menstrual cycle.⁷

Apart from light mid-cycle spotting, Dr. Traci Johnson on WebMD says that other signs of ovulation can include:⁸

• Vaginal discharge that resembles egg whites (ovulation discharge)
• Light abdominal cramping
• Increase in basal body temperature

Birth control

Birth control can sometimes cause spotting between periods as your body adjusts to the hormones. Both oral contraception and intrauterine devices (IUD) can cause irregular bleeding before or after your period.

The University of Colorado says that some pink or brown vaginal spotting between periods is normal in the first few months of starting birth control. This can happen if the estrogen levels are adjusted or you miss taking the pill at the same time every day. If you have recently had an IUD fitted, it can be normal that you experience some spotting at the start.¹⁰

Heavy vaginal bleeding is not normal when using hormonal contraception. If you notice irregular bleeding between periods that is more than spotting, and you have cramping or vaginal discharge with a fishy smell, you should speak to your doctor.

Stress

Stress can affect your hormone levels and cause intermenstrual bleeding as well as a thin, light watery period.

Stress can cause you to have irregular menstruation or you might even start missing periods. According to doctors from the National Health Service, stress is one of the most common causes of late periods. Stress can cause light bleeding or spotting between periods.¹¹

There are many ways to reduce stress naturally and help you regain a regular menstrual cycle. For example, there are many essential oils that help to reduce anxiety and stress. These natural methods for stress relief may help to stop spotting between periods.

Implantation spotting

You might experience light brown-colored or pink spotting just before you expect your period if implantation has occurred and you are pregnant. Implantation spotting will only last a few days and because you are pregnant you won’t have your period.

OB-GYN Dr. Yvonne Butler Tobah explains that implantation spotting can happen about 10 to 14 days after conception. The light pink or brown-colored spotting occurs because of the fertilized egg attaching itself to the uterus. This type of intermenstrual bleeding is lighter than regular menstrual bleeding.⁹

Implantation is one of the signs of early pregnancy, other signs that you are pregnant can include:

• Mild cramping when implantation occurs
• Changes in breast size
• Food cravings or aversions
• Headaches
• Backache
• Mood swings
• Nausea and/or vomiting

Of course, the only way to be sure if you are pregnant is to take a pregnancy test at home or at your doctor’s clinic.

Perimenopause

If you are approaching the menopause, you may notice that you have spotting between periods or you bleed more during your regular period. As your hormone levels fluctuate in the perimenopause stage you will also experience irregular periods.

Doctors from the American College of Obstetricians and Gynecologists explain that changes in progesterone and estrogen levels can cause abnormal vaginal bleeding. This can be heavy blood flow during menstruation or spotting between periods. It is always best to speak to your doctor if you notice changes to menstrual patterns or if you have vaginal bleeding after the menopause.¹²

To get relief from the symptoms of menopause, you can try some natural supplements for the menopause. Many women find relief from menopausal symptoms by using essential oils.

Thyroid disease

Because irregular menstrual bleeding is connected with your hormone levels, an underactive thyroid (hypothyroidism) can also cause pink spotting between your periods.

Dr. Millie Behera, who is an expert in reproductive endocrinology, says that hypothyroidism (underactive thyroid) can cause uterine bleeding before or after your period. Depending on your condition, the bleeding between periods could be heavy or light.¹³

If you have an underactive thyroid, please check out my article on how to treat hypothyroidism naturally.

Ovarian cysts

Some pink or brown spotting between your periods could be an indicator of ovarian cysts. Cysts on the ovaries are considered a normal part of the menstrual cycle. In the majority of cases, the cysts don’t cause any symptoms, however, they may cause pelvic pain.

According to doctors at the Center for Menstrual Disorders & Reproductive Choice, ovarian cysts that grow in size and rupture can cause intermenstrual bleeding and abdominal pain. Other symptoms of ovarian cysts include:¹⁴

• Pelvic pain that feels like a dull or sharp pain in the lower abdomen on the side of the cyst
• Bloating
• Fullness or heaviness in your abdomen

To find out more information about ovarian cysts, please read my article on the warning signs of ovarian cysts. In many cases, doctors take a “wait and see” approach to see if the cysts go away on their own or need to be treated.

Polycystic ovary syndrome (PCOS)

One reason for light spotting to heavy bleeding between periods is a condition called polycystic ovary syndrome (PCOS). This is where there are multiple cysts on the ovaries and it interferes with your hormone levels and ovulation.

According to doctors from UCLA Health, one of the symptoms of PCOS is irregular vaginal bleeding. In some cases, there can be a big gap between periods resulting in fewer than 12 menstrual cycles in a year. Other symptoms of PCOS can include:¹⁵

• Excess body hair growth and thinning hair on the scalp
• Greasy skin with outbreaks of acne
• Infertility or difficulty conceiving
• Mood swings

Some of the ways of treating the symptoms of polycystic ovary syndrome include taking Chinese licorice, cinnamon, black cohosh, or red raspberry leaf tea.

Pelvic inflammatory disease (PID)

Abnormal bleeding or spotting after your period can be a symptom of pelvic inflammatory disease. PID is a bacterial infection affecting the reproductive organs that can cause a lot of abdominal discomfort.

PID is often the result of a sexually transmitted disease but can also be caused by childbirth or an endometrial biopsy. According to researchers from the Centers for Disease Control and Prevention, pelvic inflammatory disease can cause bleeding between periods. Some other symptoms of PID include:¹⁶

• Pain and abdominal cramping but no period
• Yellow or greenish discharge that has a bad smell
• Burning sensation when you urinate
• Fever

It’s important to get prompt medical treatment if you suspect you have contracted a bacterial infection. If left untreated, PID can lead to reproductive complications, including infertility.

Pelvic congestion syndrome

Pelvic congestion syndrome is a painful condition that often results in light to heavy spotting between periods. Pelvic congestion syndrome is like having varicose veins in your pelvic area.

According to OB-GYN Dr. JoAnn Pinkerton from the University of Virginia Health System, pelvic congestion syndrome is a common cause of abdominal pain in women. It can cause dull abdominal aching or sharp, shooting pains. One of the common symptoms of pelvic congestion syndrome is abnormal uterine bleeding.¹⁷

Dr. Pinkerton says that other symptoms can include:

• Thin watery vaginal discharge
• Low back pain
• Vaginal discomfort
• Bloating
• Mood swings
• Headaches

Uterine fibroids

If you notice spotting a week or 2 weeks after your period and have heavy menstrual bleeding, it could be a sign of uterine fibroids.

According to doctors from the Mayo Clinic, fibroids on the uterus are non-cancerous growths. They can range in size from a seed to large masses that press on the reproductive organs. One of the signs  of uterine fibroids is spotting between periods along with constant nagging pelvic pain.¹⁸

Depending on the size and location of your fibroids, you may also experience any one of the following symptoms:

• Need to urinate frequently
• Difficulty emptying the bladder
• Constipation
• Lower back pain and pains in your upper thigh

Uterine polyps

Uterine polyps are soft red growths attached to the inner wall of the uterus (the endometrium). According to doctors from Mayo clinic uterine polyps (endometrial polyps) can causes bleeding between periods as well as affect the duration and frequency of your periods.²²

Uterine polyps most commonly develop in women who are going through or have completed menopause, although younger women can get them too. They are usually noncancerous (benign) but they are known to cause issues with the menstrual periods or even infertility.

The symptoms of uterine polyps include:

• Irregular menstrual periods
• Bleeding or spotting between periods
• Excessively heavy menstrual flow
• Vaginal spotting or bleeding after menopause
• Infertility

Urethral prolapse

Spotting can occur after your period if the muscles that hold your urethra in place become weakened. Urologist Dr. Bradley Gill says that irregular bleeding between menstrual periods is the most common symptom of urethral prolapse.¹⁹

You can strengthen your pelvic muscles and help prevent urethral prolapse by performing Kegel exercises.

Cancer

Mild to heavy bleeding between periods can be a sign of cancer in the reproductive organs. However, it’s good to remember that, according to the National Health Service, irregular vaginal bleeding isn’t usually a symptom of cancer.²⁰

Doctors say that vaginal bleeding associated with uterine cancer can start as light bleeding with watery discharge. In time, the bleeding will become heavier. If you have been through the menopause, it’s important to see your doctor about any kind of vaginal bleeding.

When to See a Doctor

Thankfully, occasional spotting between periods is usually nothing to worry about and it’s just part of the menstrual cycle. However, abnormal spotting or bleeding when you aren’t menstruating can be a sign of something more serious.

According to obstetrician Dr. Nivin Todd, you should visit your doctor if you have spotting before or after your period along with one or more of the following symptoms:²¹

• Lower abdominal pain
• Fever
• Persistent vaginal bleeding
• Menstruation that becomes heavier than usual
• Any vaginal bleeding after the menopause

Read my other related articles:

• What Does Implantation Bleeding Look Like?
• Dark or Black Period Blood: Causes and What to Do About It
• White Creamy or Milky Discharge: What Does It Mean?
• 10 Types of Cervical Mucus or Discharge You Need to Know About

Medical Sources