Spotting is light bleeding that can occur between periods. Many factors may cause spotting, but it is usually not a cause for concern.
When people experience vaginal bleeding at times other than during normal menstruation, doctors refer to this as intermenstrual bleeding. Spotting tends to occur between periods and can happen at any age after puberty.
Spotting is a very light bleed from the vagina. It differs from the light bleeding at the start and end of a period.
Several conditions, infections, and medications can trigger spotting. Although most reasons for spotting are mild, some can be severe.
This article explores the potential causes of spotting, and looks at when a person should see a doctor.
People usually notice they are spotting if they see a small amount of blood on toilet paper after wiping. They may also observe a few drops of blood on their underwear.
If a person is spotting, the amount of blood loss is not enough to cover a panty liner or pad.
Several factors can cause spotting, such as:
Some forms of birth control list spotting as a side effect, including
Spotting is most common in the first few months of using a new method of hormonal contraception. The bleeding will usually go away without intervention.
Spotting sometimes occurs during pregnancy. Around 25% of people experience some form of bleeding or spotting when they are pregnant.
During the first trimester, spotting can be due to:
- implantation, when the fertilized egg attaches to the lining of the uterus
- having sex
- hormonal changes
- cervix changes
- genetic testing, such as amniocentesis or chorionic villus sampling
Heavy spotting during pregnancy may indicate pregnancy loss. Other symptoms of pregnancy loss may include:
- abdominal cramping or pain
- fluid, discharge, or tissue passing from the vagina
- vaginal bleeding
- back pain
Heavy spotting can also be a sign of an ectopic pregnancy. Doctors call a pregnancy ectopic when the fetus grows outside of the uterus, usually in the fallopian tube. A person with this condition needs immediate medical attention.
An ectopic pregnancy may cause:
- vaginal bleeding
- abdominal pain on one side
- discomfort when passing urine or stool
- shoulder pain
Spotting or bleeding later in pregnancy can be a sign of going into labor or a complication, and a person should seek medical advice. If the bleeding is heavy, they should go to the delivery hospital immediately.
Menopause and perimenopause
When people stop having periods, doctors refer to this as menopause. This tends to develop at 45–55 years of age.
The years leading up to menopause are known as perimenopause, which can last up to 10 years.
During perimenopause and menopause, hormonal changes can impact the menstrual cycle, resulting in spotting.
Sexually transmitted infections
Some sexually transmitted infections (STIs), including chlamydia and gonorrhea, can trigger vaginal bleeding between periods. STIs can easily spread between sexual partners and lead to severe complications.
Other symptoms of STIs include:
- yellow vaginal discharge
- painful or frequent urination
- discharge from the rectum
- rectal bleeding