Spotting Before Period
Spotting before period is something most women experience each month. WUKA experts discuss period spotting; spotting causes and what is spotting.
What is spotting?
Spotting. Even those of us with the most regular of cycles has probably experienced this at some point in our lives. A drop or two of blood in our underwear when we least expect it, and for no apparent reason too. Whether you’re spotting a week before your period, in between periods or after your cycle ends, there’s no doubt that it has the potential to take you by surprise.
Lots of women wonder what exactly spotting is, why does it happen and what are the most common causes for it- but first let’s look at the differences between spotting and your period.
Spotting
Unexpected, light bleeding in between your normal menstrual cycle is considered as spotting. It can be light, medium or heavy and it usually lasts for around one or two days at the start or end of your period. Most women don’t need to use period protection for spotting.
Spotting or Period
Spotting just before and just after your period is usually darker in colour, and sometimes brown. This is due to it being old blood, either left behind from the previous cycle or from the end of your current cycle. This is normal- the longer blood ‘hangs around’ inside the body before it’s expelled, the darker it becomes.
Spotting before period is common for many women, and spotting towards the end of your cycle is also very normal for lots of women, and not usually a cause for concern. There is no real regular pattern to spotting, which is why it can often take you by surprise.
Bleeding
Menstrual bleeding is very different to spotting, as it occurs roughly every 28 days, for around 4-7 days. If you track your cycle, you likely know when you period is due to start, how heavy your flow usually is, and how long it will last too.
Likewise you will also be familiar with the other symptoms you usually experience during this time, such as cramps, bloating and mood changes.
If you experience irregular periods, it may be difficult to know the difference between spotting and bleeding between periods, so becoming aware of what the flow looks like is important. Menstrual bleeding is usually red, but it’s not unusual to notice changes in colour as your cycle progresses.
What causes spotting before period?
If you experience spotting before period, it’s usually coming from the upper and lower reproductive tract- the uterus or cervix. It’s totally different from the menstrual cycle, and can be down to a wide variety of causes, most of which are usually harmless.
What causes spotting after period?
Some women may also experience spotting a week after period, and again this can be down to normal functions within the body. Lots of young women especially may experience light spotting during ovulation as oestrogen levels drop dramatically.
Common causes of spotting between periods
If you’re concerned about bleeding between periods, it’s important to investigate the reasons why.
Hormonal contraception
Some types of hormonal birth control can cause spotting before period, and this is a common side effect, especially if you've just started taking them. However, if spotting continues after a few months, or you experience unscheduled light bleeding between periods, then it might be time to change your pills.
Some women most commonly experience continued spotting with the hormonal IUD and mini-pill. Speak to your doctor about alternative methods of contraception that might be more suitable for you. Find out more about how contraception can affect your period.
Ovulation
Spotting a week after period can often be due to ovulation. Ovulation spotting tends to be light pink or red, lasting for just one or two days towards the middle of your cycle.
Spotting will be accompanied by other common signs such as: an increase of cervical mucus, with a very thick, egg-white consistency; a decrease in the body’s basal body temperature (followed by a sharp increase after ovulation); a dull ache on one side of the abdomen; breast tenderness and bloating.
Breastfeeding
Women who are breastfeeding may experience spotting, due to hormonal changes in the body that are required in order to produce the milk that their baby needs.
Despite ovulation being suppressed by breastfeeding, some women also experience spotting as the body prepares to ovulate for the first time after giving birth; it’s again thought that huge hormonal shifts are to blame.
Peri menopause
During peri menopause, the body is transitioning towards some major upheavals to the menstrual cycle, and hormones are fluctuating in different ways. Many women find that they skip periods for a few months at a time, periods become very irregular and some spotting before period may occur.
If you suspect you may be in peri menopause, try to keep a track of these changes and if you’re concerned, speak to your doctor.
STIs
Some sexually transmitted diseases (STIs) can cause spotting between periods or after sex. If chlamydia or gonorrhoea are left untreated, then the infection can easily move up to the reproductive organs and can be the reason for bleeding. This can then lead to other problems, such as Pelvic Inflammatory Disease (more on that below).
Symptoms to look out for include a painful, burning sensation when you pee; a change in vaginal discharge which may be coloured white, yellow or green; itching around the vagina and/ or anus; pelvic pain. If you’re concerned, seek treatment straight away to avoid complications.
Symptoms to look out for include a painful, burning sensation when you pee; a change in vaginal discharge which may be coloured white, yellow or green; itching around the vagina and/ or anus; pelvic pain. If you’re concerned, seek treatment straight away to avoid complications.
Pelvic Inflammatory Disease
Pelvic Inflammatory Disease (PID) can cause spotting between periods, along with painful sex, pain when you pee, pain in the upper or lower abdomen, an increase in discharge and, in some cases, fever.
PID is very serious and can if you experience signs of infection, such as severe pain in the abdomen and a high temperature, you should seek medical attention straight away. The NHS advises that delaying treatment for PID can lead to serious issues that can lead to long-term health complications. If treated early, a course of antibiotics will kill off the bacteria that cause PID. Your partner will also need to be treated and you should take steps to make sure the infection is not spread to others.
If you’re concerned about PID, speak to your doctor or visit a sexual health clinic so that they can rule it out. Always practise safe sex and especially take care with new partners.
Trauma/ injury
Spotting may also occur due to some kind of trauma or injury, such as rough sex, inserting a tampon, or a vaginal examination. If you’ve experienced trauma due to a sexual assault, you can speak in confidence to someone at a sexual assault referral centre.
The NHS has more information on this service and other services available to you.
PCOS
Polycystic Ovary Syndrome (PCOS) occurs when the ovaries or adrenal glands start to produce very high amounts of androgens (male sex hormones) and can also cause spotting. Many women with PCOS have irregular periods which can often make it harder to know whether they’re experiencing a period or spotting between their period.
Symptoms of PCOS also include pelvic pain, weight gain, excessive hair growth and problems conceiving. If you think you might have PCOS, speak to your doctor about potential treatments, which include: hormonal birth control, insulin medication, or fertility drugs designed to prompt the pituitary gland to produce more follicle-stimulating hormone (FSH). This course of treatment helps to balance the levels of FSH in the body, thus helping to regulate the menstrual cycle.
Uterine fibroids
Uterine fibroids are non-cancerous growths that are found on the uterus and in many cases, women are often unaware that they have them, due to lack of symptoms. A lot of women are diagnosed via a routine vaginal examination, but others might find that spotting before periods alerts them to other symptoms too.
Some women may experience heavier or longer periods, pelvic pain, pain during sex and difficulty urinating. There are different treatments that you doctor might recommend if you have uterine fibroids, so get an appointment to discuss your options.
Ovarian cyst
Ovarian cysts are growths that occur usually due to hormonal changes in the body, often during puberty or the menopause. They’re quite common- it’s estimated that around one in ten women have them at some point in their lives, and most do not need to be treated as they tend to be benign.
Ovarian cysts may cause spotting between periods, along with other changes to your cycle such as heavy bleeding or a disruption to your regular pattern of bleeding. Very large cysts might push against the bowel or bladder, causing pain when using the loo. That said, most women don’t experience any symptoms at all and therefore probably won’t even know they have a cyst.
If you’re concerned about ovarian cysts, your doctor can advise you on whether or not treatment is needed.
Cervical or uterine polyps
Polyps are small, usually non-cancerous growths made up of tissue that appear in a variety of places, including the cervix and uterus.
Polyps can cause spotting after sex and between periods, along with a change in vaginal discharge. They’re usually diagnosed during a routine examination and your doctor might recommend removing them (which is a painless procedure), but in most cases no treatment is needed at all.
Endometriosis
Endometriosis is a condition where the lining of the uterus starts to grow outside of the womb, in places such as the fallopian tubes, ovaries, pelvis or lower abdomen. In some cases, scar tissue can develop and adhesions start to grow, which can lead to further issues affecting the pelvis and other organs.
With endometriosis, as the uterus lining breaks down in the body during your cycle, blood and tissue builds up and is not able to flow out as it normally would during you period. This causes a lot pain and discomfort for sufferers and periods are often very irregular. Lots of women will experience spotting as a result.
If you suspect you may have endometriosis, speak to your GP about your symptoms and ask to be referred for more tests. Around one in ten women are estimated to have this condition, but getting a diagnosis can be lengthy process.
Stress
Stress is known to contribute towards irregular periods, and can also be a cause of spotting before and after your period too.
Thyroid issues
Low levels of thyroid hormones, due to an under active thyroid, can affect normal functions within the body, including your menstrual cycle. Periods become irregular, with some women experiencing spotting as a result.
Other symptoms include: feelings of fatigue and extreme tiredness; weight gain; constipation; sensitivity to cold dry skin; muscle aches, joint pain and feelings of weakness; low mood; ‘puffy’ face. If you suspect you might have an under active thyroid, speak to your GP for advice on treatments available to you.
Cancer of the Uterus, Cervical, Vagina or Vulva
Sometimes, spotting between period can be a sign of something more serious. Some cancers can cause irregular or abnormal bleeding, spotting and changes in vaginal discharge.
Speak to your GP about spotting between periods so that ant serious conditions can be ruled out.
Spotting during pregnancy
If you think you could be pregnant, it’s important to take a test as soon as possible so that you have plenty of time to discuss your options with your doctor moving forward. Often, women who experience spotting are asked to rule out this out first, as this can be a common occurrence during pregnancy.
Vaginal bleeding during pregnancy should always be taken seriously, and you should call your midwife or GP straight away so that anything more serious can be ruled out.
Implantation bleeding
Some women experiencing spotting (also known as implantation bleeding) when a fertilised egg becomes attached to the uterine lining. This usually takes place a few days before your period is due and is usually light pink to dark brown in colour. Implantation bleeding is usually very light, lasting no longer than one two days in total.
If you suspect implantation bleeding, take a pregnancy test to make sure.
Cervical changes
Some pregnant women experience spotting after sex due to changes in the cervix. This is normal, and can occur at any stage during your pregnancy- but if you’re concerned, speak to your GP or midwife straight away.
Miscarriage
Spotting during the first 12 weeks of pregnancy could be sign of miscarriage. Other symptoms of miscarriage include painful cramping in the lower abdomen, discharge of fluid or tissue from the vagina and a cessation of pregnancy symptoms.
However, the NHS advises that most women who experience some spotting or vaginal bleeding at this stage go on to have a successful pregnancy.
Ectopic pregnancy
An ectopic pregnancy occurs when the egg implants outside the uterus. This is a potentially dangerous condition and the egg needs to be removed quickly.
The symptoms of an ectopic pregnancy include spotting, pain in the lower abdomen (sometimes on one side), pain in the shoulder and discomfort when using the loo. If you experience these symptoms, seek medical attention straight away.
Termination of pregnancy
The British Pregnancy Advisory Service (BPAS) advises that vaginal bleeding is normal following a termination of pregnancy, and this can last up to two weeks.
Following this, the blood flow tends to slow down, and some women may then experience light spotting, in some cases right up until their next period.This is normal, but if you’re concerned then it’s always a good idea to check in with your doctor.
Vaginal infection
During pregnancy, you are susceptible to vaginal infections which can cause spotting. Speak to your midwife or doctor about the tests and treatments available to you.
Signs of labour
Towards the end of pregnancy, the plug of mucus that is in the cervix begins to break away as the body prepares for labour. For some women, this may look like spotting, for others it’s a lot more noticeable as a ‘show’. Speak to your midwife if you have concerns about this.
