The medical definition of “spotting”

There’s nothing like those “not-quite-your-period-but-still-bleeding” moments to throw you off your game. Spotting is a common medical phenomenon—but it tends to have the worst timing.

While spotting isn’t the same thing as your period in full force, it’s an equally important indicator of your health. In some cases, it can point to an underlying condition. In other cases, it’s just a completely harmless, random annoyance. That’s why it’s so important to be aware of what causes spotting (as well as the related signs or symptoms to look out for). 

But…what is spotting, really? Isn’t it just those super-light days at the end of your period?

Technically, no! Spotting, sometimes called “intermenstrual bleeding,” refers to vaginal bleeding that occurs between your regular menstrual periods. 1 In other words, spotting is bleeding that happens at a point during your cycle when you wouldn’t necessarily expect it (such as during the luteal phase or around ovulation). 

While some people refer to the lighter days at the end of menstruation as “spotting,” those instances don’t actually qualify—if “spotting” happens around your period, it’s probably just… your period. 

Here’s how to tell the difference between spotting and your period

Most menstruators get a period about every 28 days—during those 28 days, your body goes through all four stages of the menstrual cycle. 2 On average, you’ll lose about 30 to 80 mL of blood during a period. 1 That translates to somewhere between 6 and 16 teaspoons. 

Still, according to a study published in the BMJ, about 36% of people with periods who report to primary care providers with menstrual problems have intermenstrual or post-coital bleeding in addition to heavy menstrual bleeding. 3

Unscheduled bleeding, unlike your period, does not happen cyclically. It can occur: 

  • In between normal periods 
  • Before puberty
  • After menopause 
  • During or after sexual intercourse

Spotting can also be characterized by the amount of blood that shows up in your underwear: When actually “spotting,” there shouldn’t be enough blood to cover or soak through a panty liner. 4

Sometimes, spotting can be difficult to pinpoint if your periods are irregular or very light. While there are many innocent causes of spotting, there are also a handful of more serious conditions that bring about those “random” drops of blood that make you break out that stain remover to salvage your favorite pair of underwear. 

If you’re unsure whether your vaginal bleeding is due to your period or unexplained spotting, talk to your healthcare provider or OB/GYN.

Why spotting happens: Common causes

As mentioned above, spotting may catch you off-guard, but it’s pretty common—and its possible causes can range from gynecologic to hormonal to stress-related.  

One especially common reason for spotting? Starting a new form of birth control, like the pill, patch, or IUD. To learn more about how hormonal contraceptives can affect your period and/or spotting, read all about birth control bleeding here.

Some menstruators may also experience age-related spotting. Maybe you’ve just started getting your period, in which case light or irregular bleeding is normal, or maybe you’re entering into perimenopause (which typically happens if you’re in your forties or fifties). 5 

Here are a few (but not all!) of the possible causes of spotting: 1

  • Stress
  • Uterine fibroids
  • Cervical or uterine polyps
  • Changes in hormone levels
  • Inflammation or infection of the cervix (cervicitis) or uterus (endometritis)
  • Vaginal injury or trauma 
  • IUDs
  • Ectopic pregnancy, miscarriage, or other pregnancy complications
  • Vaginal dryness due to lack of estrogen after menopause
  • Using hormonal birth control irregularly (such as stopping and starting or skipping birth control pills, patches, or estrogen rings) 
  • Underactive thyroid (low thyroid function)
  • Certain medications

The important takeaway here is that spotting can be caused by lots of different things going on in your body—from medication to stress to injury, inflammation, or a medical condition. 

Spotting doesn’t always spell trouble (and there are cases where spotting can even be expected). Conversely, there are also situations in which spotting is a cause for greater concern and something worth discussing with your primary care physician or OB/GYN. 

Different types of spotting and what they could mean

Not all spotting is created equal. That is to say, there are many different types of spotting that occur in specific circumstances. Here are a few benign types of spotting to look out for if you happen to be: 

1. Ovulation spotting

Ovulation = the phase of the menstrual cycle during which your ovary releases an egg. However, the ovulation process begins earlier than the actual egg release. Typically lasting between 16 to 32 hours in total, ovulation technically begins when the body experiences a spike in luteinizing hormone (LH). 6

Spotting during the ovulatory phase of your menstrual cycle is uncommon but not unheard of, and it may be connected to higher estrogen levels experienced during this phase. In one study, nearly 5% of participants reported an instance of spotting—lasting on average between one and two days—around or during ovulation. 7 Translation? It’s not the most typical cause for spotting, but if it does happen to you, know that it’s probably harmless. 

2. Implantation bleeding & spotting during pregnancy

Pregnancy tends to be a wonderful and also super-stressful time. And spotting during pregnancy can turn those stress levels up to 100, especially if the cause is unknown. 

Rest assured: While it can be unsettling to notice those drops of blood, ~20% of people who experience spotting while pregnant go on to have a healthy pregnancy and baby. 8 There are several situations during pregnancy where spotting is commonly seen.

One of these instances—implantation bleeding—occurs in the first trimester, when the fertilized egg implants in the uterus. 4 This type of spotting can occur before you even know you’re pregnant and may last up to a few days. If you’re experiencing unscheduled bleeding and are unsure if you may be pregnant, take a pregnancy test or consider speaking to your primary care physician or OB/GYN.

Other pregnancy-related spotting can occur due to cervical polyp, which is a relatively harmless growth on the cervix. While you could technically develop a cervical polyp at any time, polyps are more likely to grow (and thus bleed) during pregnancy. 9

In general, you should always speak to a medical provider if you’re unsure about the cause of your spotting. While spotting during pregnancy is not always a medical emergency, there are cases where bleeding while pregnant can be a sign of a more serious illness, especially in the second and third trimesters. Any bleeding, especially after the first trimester, should be reported to your obstetrician. 9

3. Breakthrough bleeding (birth control spotting)

Another common cause of spotting has to do with being on birth control—in these cases, it’s also known as breakthrough bleeding. This is common in those who’ve recently started hormonal birth control (including the pill, patch, ring, or hormonal IUD). Unscheduled bleeding on birth control can also occur if you take birth control pills irregularly or skip placebo pills.

4. Spotting during perimenopause

Perimenopause is the timeframe when people AFAB near menopause – marking the end of their reproductive years. This typically occurs in your 40s, however, some people report changes in menstrual regularity as a result of perimenopause as early as their mid-thirties. 10

In a study of perimenopausal people, 24% reported an instance of intermenstrual bleeding. In perimenopausal people, there is a higher prevalence of both spotting in between periods and spotting after sex. 11 Even with menstrual irregularity, it’s important to discuss any extremely heavy bleeding, extended bleeding over seven days, excessive spotting, or periods occurring less than 21 days apart. 10

How to manage spotting: What products to use

Spotting can be super frustrating—especially when it happens, like magic, on the exact day you chose to wear a brand new pair of white underwear from your favorite brand. Thankfully, there are period products you can use safely for spotting to help protect your clothes (or sheets) from unscheduled bleeding.

Liners, for one, are a great option to use while spotting. Since they’re thinner and more compact than regular pads, you can stash them easily in your bag (or even in your wallet) in case you have an unexpected spotting emergency.

A menstrual disc is another great choice for spotting, especially if it’s recurrent—like when you’re transitioning onto a new form of hormonal birth control. Flex Disc is made from body-safe, medical-grade polymers that glide in and out comfortably even when there isn’t a whole lot of lubrication in the vaginal canal (so you can say goodbye to that cringey dry tampon removal). 

PSA: Don’t use tampons for spotting! Doing so can actually increase your risk for bacterial infection. 

If you’re not a fan of additional period products, you can also opt to use absorbent period underwear, a liner, or just throw on your favorite pair of comfy black underwear and embrace the free bleed. 

Spotting vs. your period: Key takeaways

Your menstrual cycle doesn’t end when your period does. Your reproductive system stays in flux and it’s important to keep track of any unexpected changes in your cycle.

If you’re unsure how to approach this topic with your primary care physician or OB/GYN, here are some questions to ask yourself: 2

  • Are you pregnant?
  • How long has the spotting persisted?
  • Are there any other associated symptoms?
  • Are you taking any medications?
  • Have you missed your period or had a heavier or irregular period?

Spotting can be bothersome, but understanding and taking note of changes in your reproductive health can help you spot potential problems earlier—and, at the very least, might save you from another pair of stained underwear.

This article is informational only and is not offered as medical advice, nor does it substitute for a consultation with your physician. If you have any gynecological/medical concerns or conditions, please consult your physician. 

© 2021 The Flex Company. All Rights Reserved.

References (Click to open/close)

  1. Medline Plus. (2019, March 28). Vaginal bleeding between periods. Medline Plus. https://medlineplus.gov/ency/article/003156.htmMedline Plus. (2019, March 28). Vaginal bleeding between periods. Medline Plus. https://medlineplus.gov/ency/article/003156.htmMedline Plus. (2019, March 28). Vaginal bleeding between periods. Medline Plus. https://medlineplus.gov/ency/article/003156.htm
  2. Healthgrades Editorial Staff. (2021, January 8). Spotting. Healthgrades. https://www.healthgrades.com/right-care/womens-health/spottingHealthgrades Editorial Staff. (2021, January 8). Spotting. Healthgrades. https://www.healthgrades.com/right-care/womens-health/spotting
  3. Warner, P., Critchley, H. O., Lumsden, M. A., Campbell-Brown, M., Douglas, A., & Murray, G. (2001). Referral for menstrual problems: cross-sectional survey of symptoms, reasons for referral, and management. BMJ (Clinical research ed.), 323(7303), 24–28. https://doi.org/10.1136/bmj.323.7303.24
  4. Medline Plus. (2018, September 25). Vaginal bleeding in early pregnancy. Medline Plus. https://medlineplus.gov/ency/patientinstructions/000614.htmMedline Plus. (2018, September 25). Vaginal bleeding in early pregnancy. Medline Plus. https://medlineplus.gov/ency/patientinstructions/000614.htm
  5. Villavicencio J, A. R. (2016). Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates. Open Access J Contracept, n/a(n/a), 43-52. https://doi.org/10.2147/OAJC.S85565
  6. Knudtson, J., & McLaughlin, J. E. (2019, April). Menstrual Cycle. Merck Manual. https://www.merckmanuals.com/home/women-s-health-issues/biology-of-the-female-reproductive-system/menstrual-cycle 
  7. Sonya S. Dasharathy, Sunni L. Mumford, Anna Z. Pollack, Neil J. Perkins, Donald R. Mattison, Jean Wactawski-Wende, Enrique F. Schisterman. (2012, March 15). Menstrual Bleeding Patterns Among Regularly Menstruating Women. American Journal of Epidemiology, 175(6), 536–545. https://doi.org/10.1093/aje/kwr356
  8. Warner, P., Critchley, H. O., Lumsden, M. A., Campbell-Brown, M., Douglas, A., & Murray, G. (2001). Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management. BMJ (Clinical research ed.), 323(7303), 24–28. https://doi.org/10.1136/bmj.323.7303.24 
  9. American Pregnancy. (2020, July 13). Spotting During Pregnancy. American Pregnancy. https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/spotting-during-pregnancy-5374/American Pregnancy. (2020, July 13). Spotting During Pregnancy. American Pregnancy. https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/spotting-during-pregnancy-5374/
  10. Mayo Clinic Staff. (2020, December 21). Perimenopause. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Mayo Clinic Staff. (2020, December 21). Perimenopause. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 
  11. Shapley, M, Blagojevic‐Bucknall, M, Jordan, KP, Croft, PR. (2013, October). The epidemiology of self-reported intermenstrual and postcoital bleeding in the perimenopausal years. BJOG: An International Journal of Obstetrics & Gynaecology, 120(11), 1348-1355. 10.1111/1471-0528.12218