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Spotting Between Periods

Medically Reviewed by Neha Pathak, MD on September 20, 2021

Why Am I Spotting Between Periods?

Most women have spotting between their periods at some point. Usually, it’s nothing to worry about. A number of things can cause it to happen. These are the most common:

  • Hormone-based birth control. If you’re on birth control that contains hormones (pills, patches, shots, rings, or implants), you might spot during the first 3 months of using it. Doctors call this “breakthrough bleeding.” They believe the extra hormones may cause changes in the lining of your uterus.
  • Some sexually transmitted infections (STIs), like chlamydia
  • Infection of the cervix or lining of your uterus
  • Blood clotting disorders, like von Willebrand disease
  • Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease
  • Fibroids or polyps. These are noncancerous tumors that grow in the lining or muscle of the uterus.
  • Polycystic ovary syndrome (PCOS). If you have this condition, your ovaries don’t release eggs the way they should. Your ovaries become enlarged with fluid-filled sacs that surround your eggs. Your body also makes too many male hormones (called androgens). This can lead to irregular periods, spotting, and sometimes no period at all.
  • Cancers of the reproductive system. These include uterine cancer. They’re most common in women who’ve already gone through menopause. But if you’re over 40 and spotting between periods, see the doctor to rule out more serious problems.
  • Perimenopause. As you get closer to menopause, your periods might be harder to predict. Your hormone levels change, and the lining of your uterus gets thicker. This can sometimes lead to spotting.

When Should I Call the Doctor?

Make an appointment if spotting concerns you, or if you have spotting along with the following symptoms:

  • Pain in your lower abdomen
  • Fever
  • Symptoms that get worse or happen more often
  • Any type of vaginal bleeding -- including spotting -- after you’ve gone through menopause

Spotting is different from persistent bleeding, and any woman with persistent, heavy, or prolonged bleeding should make an appointment to get it checked out.

You should also see a doctor if you think you might be pregnant.

Call 911 if you have unusual vaginal bleeding with:

Take notes about your menstrual cycle and the length and heaviness of the bleeding to help your doctor figure out what’s going on. They may order blood tests or other tests, like a transvaginal ultrasound or endometrial biopsy.

Spotting Between Periods: Complications

Abnormal vaginal bleeding may be minor. But it could signal something more serious or even life-threatening, such as a benign growth like a polyp or fibroid, a bleeding disorder, an infection, or an injury. It’s rare, but spotting can sometimes be a sign of cancer. To be safe, have your doctor check it out.

WebMD Medical Reference

Sources

SOURCES:

UpToDate: “Abnormal Uterine Bleeding (Beyond the Basics).”

Mayo Clinic: “Vaginal Bleeding.”

University of Colorado: “Abnormal Vaginal Bleeding & Birth Control.”

Cleveland Clinic: “Bleeding Between Periods? How to Tell If It’s a Problem,” "General Gynecology: Reasons for Problem Bleeding."

Lee S. Benjamin, MD, spokesperson, American College of Emergency Medicine; associate program director of emergency medicine, Duke University Medical Center, Durham, N.C.

American Congress of Obstetricians and Gynecologists: "Abnormal Uterine Bleeding."

Merck Manuals: "Dysfunctional Uterine Bleeding."

Vaginal Bleeding Information from eMedicineHealth.

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