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
- 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:
- Skin that appears unusually pale
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.
Other Reasons for Bloody Vaginal Discharge
You can expect your period to stop when you’re pregnant. But 15%-25% of women have some bleeding during the first trimester.
- Light bleeding may happen 1-2 weeks after the fertilized egg implants in your womb.
- Your cervix may bleed more easily as it gains more blood vessels.
- You may notice spotting after sex, a Pap test, or a pelvic exam.
If you’re pregnant and find more than a little bit of blood, especially after the first trimester, call your doctor right away. This could be a sign of:
- Miscarriage, which usually happens in the first 13 weeks
- Ectopic pregnancy, when the fertilized egg implants outside the uterus
- Preterm labor
- Problems with your cervix
- Problems with your placenta
Menopause and hormone replacement therapy
Menopause is when you permanently stop getting your period, but it doesn’t happen overnight. You may have symptoms for years. A common one is light, irregular bleeding, which might seem like bloody discharge.
There’s another reason why women in the early stages of menopause often have unusual vaginal bleeding. Some of them take hormone replacement therapy (HRT) to control their symptoms. HRT is a common cause of uterine bleeding.
Don’t assume that any blood you see is due to changes in your body as you near menopause – or any medicine you take. It’s better to play it safe and call your doctor, especially since endometrial and uterine cancer are more common in older women than younger ones.
Treatment Options for Other Vaginal Bleeding
Treatment for other vaginal bleeding depends on what’s causing it, your age, and if you want to become pregnant. It’s always best to check with your doctor for your treatment options.
If it’s due to the contraception you are using or menopause hormone therapy, you may want to try another contraception or a different pill.
Your bleeding could also be due to some type of polyp, fibroid, or thickening in your endometrium.
If it is a polyp, you’ll want to check it out to make sure it is not cancerous. Surgery could be an option for removing benign (non-cancerous) polyps.
Here are some of the treatment options:
- Dilation and curettage (D&C) (Scraping of tissue from your uterus lining)
- Endometrial ablation (Destroys the lining of your uterus)
- Myomectomy (Removes fibroids, but not your uterus)
- Hysterectomy (Removes your uterus)
- Uterine artery embolization (Blocks vessels that fibroids use to grow)
If you have some type of infection, your doctor may give you antibiotics. They may also check for a sexually transmitted infection (STI) and give you and your partner the appropriate prescription.