Spotting 101: What It Is & What It Actually Means

Unlike your period, which for a lot of people comes regularly every month, spotting can be less predictable and often occurs at unexpected times throughout your cycle. But what is the clinical definition and why does it happen? We went to three female health experts to find out.

You’re Confusing It With Your Period

It can be unnerving to notice bleeding when you’re not expecting it, but before you panic, it’s worth knowing the difference between spotting and your period. Jenna Longoria, aka The Period Guru, explains your period is the first day of your menstrual cycle. “Your period lasts anywhere between three to seven days and is a result of the uterine lining shedding. A true period takes place when there’s a rise in oestrogen, causing an LH surge, prompting ovulation, then a rise and fall of progesterone. A breakthrough bleed, meanwhile, happens when the uterine lining builds under the effects of oestrogen and when it gets too heavy, it sheds. A withdrawal bleed, on the other hand, happens due to a drop in synthetic hormones when on hormonal birth control.” Jenna explains that spotting a few days before your period is normal (but not ideal), but if it’s more than three days consistently, you should speak to your doctor. GP and medical broadcaster Dr Sarah Jarvis MBE also says the colour of your period blood is very different to the colour of spotting: “Spotting is often pink or pinky-red rather than ‘real’ red. It may also be brownish.”

You Have An STI

In women, both chlamydia and gonorrhoea can cause irregular spotting between periods. If you have recently had unprotected sex and are experiencing spotting, it could be worth getting tested – either at a sexual health clinic, GUM clinic, GP surgery or via an at-home testing kit. 

You’re Ovulating

Spotting during ovulation isn’t common, but it can definitely happen, says Sarah. “Up to one in 30 women experiences spotting around the middle of their cycle when they ovulate. However, this tends to be just for a day or so and is usually at a predictable time each month. If spotting happens at other times in your cycle, you should not assume this is the case. Very uncommonly, spotting between periods can be a sign of a pelvic infection (usually sexually transmitted) or of cancer – either of the cervix, endometrium, vagina or vulva. Unless you know your spotting is related to ovulation, or have been told by your doctor you don’t need to worry (for instance, you’ve just had the coil inserted), it should always be checked out.” Jenna adds that spotting during ovulation is actually a sign of fertility and nothing to worry about.

You’re Pregnant

According to statistics, 30% of women experience spotting in their first trimester. In fact, spotting can be an early sign of pregnancy. Pregnancy implantation occurs two weeks after a fertilised egg makes its way into the lining of the uterine wall – this can cause a small amount of internal bleeding and as this blood works its way down the vagina, this manifests as spotting. This spotting is usually accompanied by breast tenderness, mood swings or nausea – a pregnancy test can detect an early pregnancy within a few weeks. 

Your Pill Is Playing Up

If you’re taking the combined pill (the most common type of birth control pill), you may have spotting that goes away after a couple of months. If, however, spotting between withdrawal bleeding continues, your pill may not be the best fit for you, and you may want to try another pill with a different chemical make-up. Spotting can also occur if you forget to take your pill, leading to a drop in hormones in your body, and is common if you’ve taken the morning after pill, says Sarah.

You Just Had The Coil Fitted

Spotting is a common side effect of hormonal contraception, especially if you recently had the coil fitted. “Sometimes, starting a new form of contraception will contribute to a longer period, or bleeding and spotting between periods,” explains Meghan Holton, Saalt menstrual cup expert. “When getting the IUD, some women completely cease bleeding and don’t have a period at all, while others will have long and irregular periods for up to six months while their body regulates to the new hormones.”

Your Hormones Are Out Of Whack

“The most common causes of spotting are low levels of progesterone, elevated cortisol levels (the stress hormone) and an underactive thyroid,” says Jenna. “Spotting is common but that doesn’t mean it’s normal. Spotting at ovulation is normal but spotting outside of ovulation points to a hormone imbalance.” In fact, research shows cortisol can delay, or even prevent, ovulation. High levels of cortisol can also interfere with the production of progesterone, and decreased progesterone can cause spotting. So when you’re stressed, your period may show up late, early, or stop altogether.

You’re Going Through The Menopause

Spotting around the time of menopause is fairly common, according to the experts, mainly due to changes in hormone levels that regulate your cycle. If you experience very heavy or lengthy bleeding during the menopause, you should speak with your doctor. “Remember hormones are powerful – they turn us from babies and children into fully-fledged adults. Spotting can occur when there are changes in hormone levels, which happens at many different times throughout a person’s life cycle, including the hormonal surges of the teenage years, postpartum and during menopause,” Meghan adds. 

You Have PCOS

Polycystic ovarian syndrome (PCOS) is the most common hormonal condition for reproductive-aged women, affecting up to 27% of women during these years. It happens when the body overproduces androgens, leading to physical symptoms such as irregular and painful periods, acne, hair growth, weight gain and spotting. “Women with PCOS are more likely to experience spotting between their periods,” Sarah says. 

Although spotting isn’t usually a sign of anything serious, it isn’t normal. Any time you notice bleeding outside of your period, mention it to your GP – this is especially important if you are pregnant. For more information, visit the NHS website. Visit Saalt.com, JennaLongoria.com and MyLivia.com. Livia is a scientifically proven portable device that can instantly switch off period pain for women.

 

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