Why Am I Spotting Between Periods?

Spotting is light vaginal bleeding that occurs outside of your regular period.

Spotting typically involves small amounts of blood. You may notice it in your underwear or on toilet paper after you’ve used the restroom. If you need protection, it usually only requires a panty liner — not a pad or tampon.

Bleeding any time other than when you have your period is considered abnormal vaginal bleeding, or intermenstrual bleeding.

Spotting has many causes. It can sometimes be a sign of a serious problem but not often. Keep reading to learn why you might be spotting between periods and when to see a doctor.

There are several reasons you may experience spotting before your period, including:

1. Pregnancy

Spotting during pregnancy is common. About 15 to 25 percent of pregnant people will experience spotting during their first trimester.

The bleeding is often light and may be:

• pink
• red
• brown

Spotting typically isn’t a cause for concern, but you should tell a doctor if you have it. Contact a doctor right away if you experience heavy bleeding or pelvic pain, as those could be a sign of miscarriage or an ectopic pregnancy.

2. Birth control

Spotting between periods can be caused by hormonal birth control:

• pills
• patches
• injections
• rings
• implants

Spotting can happen spontaneously or if you:

• start a hormone-based birth control method
• skip doses or take birth control pills not according to the package instructions
• change the birth control type or dose
• use birth control for a long time

Birth control is sometimes used to treat abnormal bleeding between periods. Talk with a doctor if your symptoms don’t improve or get worse. They may prescribe a different birth control method.

3. Ovulation

According to an older 2012 study on menstruating women, about 4.8 percent experienced spotting related to ovulation.

Ovulation spotting is light bleeding that occurs around the time in your menstrual cycle when an ovary releases an egg. This typically occurs 14 days before menstruation.

Ovulation spotting may be light pink or red and last for 1 to 2 days in the middle of your cycle.

Other signs and symptoms of ovulation may include:

• an increase in cervical mucus
• cervical mucus with the look and consistency of egg whites
• a change in the cervix’s position or firmness
• a decrease in basal body temperature before ovulation, followed by a sharp increase after ovulation
• increased sex drive
• a dull ache or pain on one side of the abdomen
• breast tenderness
• bloating
• an intensified sense of smell, taste, or vision

Paying close attention to these symptoms may also help you identify your window to conceive if you are trying to get pregnant.

4. Perimenopause

As you transition to menopause, there may be months when you don’t ovulate. This transitional time is called perimenopause.

During perimenopause, periods become more irregular, and you may experience spotting. You may also skip periods or have menstrual bleeding that’s lighter or heavier than usual.

5. Cancer

Certain cancers can cause:

• abnormal bleeding
• spotting
• other forms of vaginal discharge

These cancers may include:

• endometrial (uterine) cancer
• cervical cancer
• ovarian cancer
• vaginal cancer

Spotting is not often a sign of cancer, but you should talk with a doctor if you experience it, especially if you’ve already been through menopause.

6. Implantation bleeding

Implantation spotting may occur when a fertilized egg attaches to the inner uterine lining. About 15 to 25 percent of pregnant people experience bleeding in early pregnancy.

If implantation spotting does occur, it will often happen a few days before your next period begins. Implantation bleeding is usually light pink to dark brown. It can be shorter and lighter in flow than a typical period.

You may also experience:

• headaches
• nausea
• changes in mood
• light cramping
• breast tenderness
• lower back pain or ache
• fatigue

Implantation bleeding isn’t dangerous to a fetus. But you should seek medical attention if you experience heavy bleeding while pregnant.

7. Trauma

Trauma to the vagina or cervix can sometimes cause irregular spotting.

Examples of trauma can include:

• sexual assault
• rough sex
• an object, such as a tampon
• a procedure, like a pelvic exam

8. Uterine or cervical polyps

Polyps are small tissue growths that can occur in multiple places, including the cervix and uterus. Most polyps are benign, or noncancerous.

Cervical polyps can cause:

• light bleeding after sex
• light bleeding between periods
• unusual discharge

A doctor can easily see cervical polyps during a routine pelvic exam. You generally don’t need treatment unless they’re causing bothersome symptoms. If a doctor recommends removing them, it is generally easy and not painful.

You can typically see uterine polyps on imaging tests like ultrasounds. They’re most often benign, but only a small percentage become cancerous.

Uterine polyps can cause:

• irregular menstrual bleeding
• heavy periods
• vaginal bleeding after menopause
• infertility

Some people may experience only light spotting from polyps, and others may experience no symptoms.

9. Sexually transmitted infection

Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, can cause spotting between periods or after sex.

Other STI symptoms can include:

• painful or burning urination
• white, yellow, or green vaginal discharge
• itching of the vagina or anus
• pelvic pain

Contact a doctor if you suspect you may have an STI. Many STIs can be treated with minimal complications when caught early.

10. Pelvic inflammatory disease

Abnormal bleeding between periods is a common symptom of pelvic inflammatory disease (PID). You can develop PID if bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries.

Other PID symptoms can include:

• painful sex or urination
• pain in the lower or upper abdomen
• fever
• increased or foul-smelling vaginal discharge

PID can be severe or life threatening if the infection passes to the blood. If you experience signs of an infection or symptoms of PID, see a doctor for diagnosis and treatment.

Therapies, such as antibiotics, can treat most bacterial infections that cause PID.

11. Fibroids

Uterine fibroids are growths on the uterus. In some cases, they can affect fertility, making it harder to get pregnant or maintain a pregnancy.

In addition to spotting between periods, they can cause:

• heavy or longer periods
• pelvic pain
• lower back pain
• painful intercourse
• urinary problems

Some people with uterine fibroids don’t experience any symptoms.

Fibroids are typically benign and may shrink on their own.

12. Endometriosis

Endometriosis is when endometrium-like tissue grows outside the uterus in areas like the:

• ovaries
• abdomen
• bowel

It can cause bleeding or spotting between periods, as well as other symptoms.

About 1 in every 10 people of reproductive age with a uterus is believed to have endometriosis. However, many cases go undiagnosed.

Other signs and symptoms of endometriosis can include:

• pelvic pain and cramping
• painful or heavy periods
• painful intercourse
• infertility
• painful urination or bowel movements
• diarrhea, constipation, bloating, or nausea
• fatigue

13. Polycystic ovary syndrome

Irregular bleeding between periods can be a sign of polycystic ovary syndrome (PCOS). This condition occurs when a person’s ovaries or adrenal glands produce high amounts of androgens or “male” hormones.

This can affect menstrual period regularity and also make it harder to get pregnant. It typically occurs during childbearing years.

Other PCOS symptoms can include:

• irregular menstrual periods
• pelvic pain
• weight gain
• excessive hair growth
• infertility
• acne

Medications that commonly treat PCOS include:

• Hormonal birth control. Birth control may be available in a pill, patch, vaginal ring, or hormonal intrauterine device (IUD) to help balance your hormone production.
• Insulin medication. Metformin is a prescription drug commonly used to improve insulin levels in people with type 2 diabetes. It may also help regulate the menstrual cycle.
• Fertility medication. Prescription fertility drugs, such as clomiphene (Clomid), cause the pituitary gland to produce more follicle-stimulating hormone (FSH).

14. Stress

Stress can cause all kinds of changes in your body, including menstrual cycle fluctuations. Some people may experience vaginal spotting from high levels of physical or emotional stress.

15. Medications

Certain medications can cause vaginal bleeding between periods. These include:

• blood thinners
• thyroid medications
• hormonal drugs

A doctor may take you off these drugs or recommend alternatives if you experience abnormal vaginal bleeding.

16. Thyroid problems

Having an underactive thyroid (hypothyroidism) can cause spotting after your period ends.

Having hypothyroidism means that your thyroid does not produce enough of the thyroid hormones that regulate many of the body’s processes — including menstruation. These processes can slow down.

Other signs of hypothyroidism can include:

• fatigue
• weight gain
• constipation
• dry skin
• sensitivity to cold
• hoarseness
• thinning hair
• muscle aches or weakness
• joint pain or stiffness
• high cholesterol
• puffy face
• depression
• slowed heart rate

Doctors may treat this condition with hormone pills, such as levothyroxine, if necessary.

Spotting is different from the bleeding you experience during your period.

Typically, spotting:

• is lighter in flow
• is pink, reddish, or brown
• doesn’t last longer than 1 or 2 days

Bleeding due to your menstrual period:

• is usually heavy enough to require a pad or tampon
• lasts 4 to 7 days
• produces a total blood loss of about 30 to 72 milliliters (mL)
• occurs every 21 to 35 days

If you’re of reproductive age and think you might be pregnant, you can take an at-home test. Pregnancy tests measure the amount of human chorionic gonadotropin (hCG) in your urine. This hormone rises rapidly when you’re pregnant.

If your test is positive, make an appointment with an OB-GYN to confirm the results.

You should also see a doctor if your test is negative, but your period is more than a week late. A doctor can run tests to determine if an underlying condition is responsible for your missed period.

You should see a doctor if you have unexplained spotting between periods. Although it may be nothing to worry about and may go away on its own, it could also be a sign of something serious.

If you don’t already have a doctor, the Healthline FindCare tool can provide options in your area.

Record when your spotting occurs as well as any other symptoms you experience so you can share the information with a doctor.

See a doctor right away if you experience any of the following symptoms in addition to spotting:

• fever
• dizziness
• easy bruising
• abdominal pain
• heavy bleeding
• pelvic pain

You should also see a doctor if you’ve already been through menopause and experience spotting.

To determine what’s causing your symptoms, a doctor may:

• perform a pelvic exam
• order blood tests
• recommend imaging tests

Your treatment will depend on what is causing your spotting.

If your spotting is caused by a hormonal imbalance, doctors may recommend hormone medications. If a bacterial infection is to blame, a doctor may recommend antibiotics to clear up the infection.

Connect with a doctor for a diagnosis. This can help determine the best approach to help you manage spotting.

A variety of factors can cause spotting before your period. Some require prompt medical treatment, while others are harmless.

Although it’s common, any vaginal bleeding that happens outside of your period could be a sign of pregnancy or a medical condition. You should see a doctor if you experience spotting, especially if you have already gone through menopause.