The term spotting is used to refer to any vaginal bleeding that women and people with a menstrual cycle experiences between periods. It can have a variety of different causes and can appear different from person to person.
Some markers of spotting might include:
- Unexplained or irregular timing: It may stop and start or occur intermittently over the course of the month.
- Connection to the menstrual cycle: Some spotting is not so irregular and actually happens each month along with things like ovulation.
- Association with injury or abdominal pain
- Different color, texture, or smell from typical menstrual blood.
- Possibly related to hormonal birth control.
Sometimes spotting is completely normal, but sometimes it can indicate an underlying medical condition.
“Spotting can be completely normal or VERY SERIOUS depending on age and medical context.” says Bianca Palmisano, MSN, RN, SANE. “People who have stopped menstruating completely for 12 months and suddenly have bleeding or spotting should be evaluated by a healthcare professional immediately, as this could be a sign of cancer.”
Common Causes of Spotting
Several things can cause spotting including: ovulation, uterine fibroids or polyps (these will often be accompanied by things like irregular periods and pelvic pain), implantation bleeding (which happens when sperm fertilizes an egg), use of hormonal contraceptives, especially as the body first adjusts to them, breastfeeding, injuries, miscarriage, STIs like gonorrhea and pelvic inflammatory disease (PID), and, more rarely, cancers including vaginal cancer, cervical cancer, uterine cancer, and ovarian cancer.
That can sound scary but Palmisano reminds us, “For most people of reproductive age, spotting is a sign of a minor disruption in your menstrual cycle. This can be caused by stress, illness (covid-19 infection has been anecdotally associated with menstrual irregularities), or change in diet, including significant weight change.”
When to See a Doctor About Spotting
While spotting can be completely normal, there are some circumstances that definitely warrant seeking the help of a medical professional.
These include spotting that:
- May be caused by an injury or physical trauma
- Is very heavy, causes dizziness, or has a strong odor
- Persists for several days
- Comes with pain
Additionally, Palmisano points out that “Spotting after sex may be a sign of an infection!” and advises premenopausal people to “see a healthcare provider when spotting continues for multiple months, is accompanied by pain, unexplained weight loss, unusual discharge, or a smell not normal for that person.”
