Spotting – What causes bleeding between periods?

When it happens for the first time, telling it apart from a regular period can be difficult. Besides, unexpected and untimely bleeding can leave you stressed about your health. Fortunately, more often than not, spotting is not the result of a serious underlying medical condition. In some cases, it can be. 

Paying attention to the timing, intensity and duration of spotting before seeking medical advice can help your doctor determine the cause or correlate it to any pre-existing medical conditions you may have. 

To help you lookout for the right indicators of spotting, let’s take a look at how it differs from a period and what are some of the common causes behind it: 

Spotting vs Period – How can you tell the two apart 

The period or menstrual bleeding takes place every 28 to 30 days in most non-pregnant women of reproductive age. The uterine lining thickens every month to prepare for a pregnancy. When a woman is not pregnant, this uterine lining sheds, leading to bleeding for 3 to 7 days – known as your monthly period. 

Spotting, on the other hand, is light bleeding that occurs between your menstrual cycles. The amount of blood discharged from the vagina is relatively small and you don’t need a tampon or pad for protection. Some women may need to use a panty liner when this happens.

Also known as inter-menstrual bleeding, spotting occurs intermittently and irregularly, and often without any forewarning or symptoms such as cramping or mood swings. 

The tell-tale difference between the two types of vaginal bleeding are: 

• A period is a regular, monthly phenomenon (unless it's disrupted by medical conditions or pregnancy). Spotting is irregular, intermittent and unexpected. 
• A period lasts for 3 to 7 days. Spotting may last a few hours or a couple of days. It may even happen one day, stop the next and resume again. 
• A period is accompanied by hormone-triggered symptoms such as cramping, mood swings, tenderness of breasts. These symptoms typically surface during spotting 
• Menstrual blood is deep red, often discharged in the form of clots or strings, whereas the blood during spotting is either brownish or light in colour. 

What causes spotting? 

There are a broad range of reasons behind spotting. While most of these are not a cause for concern, some can be. Here are the top nine causes that may lead to inter-menstrual bleeding in women: 

1. Birth Control: Hormone-based birth control measures such as pills, rings, implants and injections are a common trigger for spotting, especially when you start using one. Missing doses, incorrect use or dosage, as well as a birth control method gone ineffective, can also cause you to bleed between periods. 
2. Implantation bleeding: Some women may experience light bleeding or spotting when a fertilised egg attaches itself to the uterine lining. This is known as implantation bleeding. While this doesn’t happen to everyone, the chances of experiencing it are higher if you get pregnant close to the date of your next period. In this case, the blood can be either dark brown or light pink. It typically resolves on its own in a day or two. While the blood flow is much lighter during implantation bleeding, it can mimic some of the period symptoms such as cramping, nausea, mood swings, breast tenderness and backache. 
3. Ovulation: Nearly 3 percent of women of reproductive age experience spotting when they ovulate. If you experience bleeding between days 11 and 21 of an ongoing menstrual cycle, it could be due to an egg being released from your ovary. This may or may not be a monthly occurrence and that’s why making that correlation can be hard. But if you see other signs of ovulation such as clear cervical mucus discharge, bloating, increased libido or your tracker tells you that you’re in your fertile days, a brief spell of bleeding isn’t a reason to get alarmed. 
4. Pregnancy: Almost a quarter of pregnant women may experience light bleeding in their first trimester. While spotting during the early days of pregnancy isn’t concerning, you must discuss it with your doctor. In case, the bleeding progresses to a heavier flow, it warrants immediate medical attention as it could a sign of miscarriage or ectopic pregnancy. 
5. Physical trauma: Any physical trauma caused to the vaginal cavity or cervix can also lead to spotting. In this case, the intensity of the bleeding depends on the severity of the trauma. Rough sex, tissue damage due to insertion of a foreign object, pelvic exams, sexual assault or rape can cause a woman to bleed. 
6. Pre-existing medical conditions: Women who suffer from reproductive health issues or pre-existing medical conditions such as uterine fibroids, cervical polyps (abnormal tissue growth in the cervix), pelvic inflammatory disease, endometriosis, PCOD or PCOS can experience spotting from time to time. In addition to this, other medical conditions such as malfunctioning thyroid, kidney disease, diabetes or bleeding disorders can also be an underlying cause. 
7. Sexually transmitted infections: STIs such as gonorrhoea and chlamydia are also among the common causes of spotting, particularly after sexual intercourse. In such cases, apart from spotting, a woman may also experience symptoms like pelvic pain, itching in the anus or vagina, burning or painful urination, and yellow, green or white vaginal discharge that is foul-smelling. 
8. Medication: Certain medicines such as hormonal drugs, medication for thyroid and blood thinners can also cause light bleeding between periods. 
9. Cancer: If spotting is recurrent and frequent, especially after menopause, it could be a sign of ovarian, cervical, uterine or endometrial cancer. Though this is a slim possibility, it’s best to seek medical advice if you feel that the bleeding is abnormal or unusual. 

The next time you experience spotting, don’t freak out. Correlate it to your medical history or other symptoms, and you may realise you have nothing to worry about. Even so, it’s always advisable to discuss it with your doctor and get a conclusive diagnosis.

To protect the identity, the person in the picture is a model. 

Have a similar problem? Share with Love Matters (LM) on our Facebook page. If you have a specific question, please ask LM experts on our discussion forum. We are also on Instagram, YouTube and Twitter. 

Arushi Chaudhary is a freelance journalist and writer with 5 years of experience in print publications such as the Pune Mirror and Hindustan Times, and has spent close to a decade writing for digital platforms and print publications – The Tribune, BR International magazine, Make My Trip, Killer Features, The Money Times, and Home Review, to name a few. Of the many things she's written about over the years, exploring the space of love and relationships through the prism of psychology excites her the most. Writing is her first and forever love. You can find her on Twitter here.