This article was medically reviewed by Luba Lee, FNP-BC, MS and by How.com.vn staff writer, Danielle Blinka, MA, MPA. Luba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
There are 12 references cited in this article, which can be found at the bottom of the page.
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Spotting between periods can be normal, so try not to worry. Your bleeding is likely normal if you're expecting your period, may be ovulating, using an intrauterine device (IUD), or just changed birth control. Otherwise, spotting between periods is typically abnormal. You can identify abnormal bleeding by checking for fever, pain, discharge, dizziness, and bruising. Additionally, consider if a medical condition, pregnancy, or sex could be causing your bleeding. However, you really need to visit your doctor if you have frequent spotting or also have other symptoms.
Steps
Recognizing Normal Spotting
Check if your period is expected in a few days. Noticing blood on your toilet paper or underwear can be scary if it's not time for your period. However, it's totally normal to notice spotting within a week of your period. Check the calendar to see if your period is coming soon. If it is, your spotting is probably normal.[1]- It's helpful to track your period so you can tell what's normal and what isn't. You may have spotting every month in the days before your period, which could be normal for you.
- If you've never had spotting before your period, it's possible that something is wrong. You likely don't need to worry, but call your doctor to be sure.
Determine if you might be ovulating, which may cause spotting. It's totally normal to see a little spotting after you ovulate.[2] Ovulation spotting happens when your egg drops out of your ovary. Usually, it'll look pink because it's blood mixed in with your cervical discharge. Check the calendar to see if you're in day 10 to 16 of your menstrual cycle, which may mean you're ovulating.[3]- Your menstrual cycle begins on the first day of your period. Normal ovulation will occur sometime around day 14. This will usually be a few days or about a week after your period ends.
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Expect spotting in the first few months of using a new birth control. Both birth control pills and an intrauterine device (IUD) can cause spotting between periods. This is a normal side effect of the hormones from oral contraceptives or the implantation of an IUD. If you've started a new birth control in the previous 3 months, consider that it may be the cause of your spotting.[4]Variation: If you have an IUD, spotting can occur from the device slipping and scratching the inside of your uterus. If this is the case, you may also notice bleeding, pain, and heavier periods. See your doctor if you're worried this may have happened.
Consider if you've recently used emergency contraception. While emergency contraception is safe, it may potentially cause spotting after you use it. This is usually nothing to worry about unless it continues. If you're feeling concerned, see your doctor to make sure everything is okay.[5]- For instance, you may experience light spotting after taking Plan B.
- While bleeding is a rare side effect of emergency contraceptive, it can happen because of the hormones in the pill.
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Identifying Abnormal Spotting
Notice if you're experiencing other symptoms. You may have abnormal spotting due to a pelvic infection, medical condition, or cancer. Try not to worry because there are many harmless causes of spotting. Instead, monitor yourself for other possible symptoms of a medical condition. See your doctor if you notice these symptoms:[6]- Easy bruising
- Fever
- Dizziness
- Abdominal or pelvic pain
- Abnormal discharge
Determine if your spotting could be a symptom of PCOS. Polycystic ovary syndrome (PCOS) is a hormonal condition that commonly causes irregular periods, among other symptoms. As part of your irregular periods, you may experience spotting. If you know you have PCOS, consider if it might be the reason behind your spotting.[7]- Symptoms of PCOS include irregular periods, excess facial and body hair, acne, male-pattern baldness (hair thinning at your temples or your crown), and enlarged ovaries. See your doctor if you suspect you may have undiagnosed PCOS.[8]
Consider if the spotting happened after sexual intercourse. You might have bleeding after sex due to scratching inside your vagina or because of a medical issue. Sometimes this is no big deal, but it can be a cause for concern. If you've only experienced spotting once, it's likely nothing is wrong. However, it's best to talk to your doctor if you have spotting after sex more than once or you're very concerned.[9]- If you have vaginal dryness, you're more likely to have spotting after sex. If this is the case, using a lube may help you avoid spotting in the future.[10]
Take a pregnancy test if you could be in the early weeks of pregnancy. Spotting can happen in the early days of pregnancy when your baby attaches to the lining of your uterus. However, it may also happen in the first few weeks. If you may be pregnant, take a home pregnancy test to find out if this could be the cause of your spotting.[11]- If the results are negative but you don't get your period, take the test again or talk to your doctor.
Get checked by your doctor if you're pregnant. Try not to worry, but it's possible that spotting can be a sign that something is wrong with your pregnancy. Go to your doctor to make sure you're not have an ectopic pregnancy, which means your baby is growing in your fallopian tubes. Additionally, your doctor can make sure you aren't experiencing early symptoms of a miscarriage.[12]- If something is wrong, your doctor will begin treatment immediately to help you and your baby.
- While this is scary, it's possible that nothing is wrong. Just make sure you see your doctor immediately to be on the safe side.
Evaluate your risk for a sexually transmitted disease (STD). Some STDs can cause vaginal spotting. You're more likely to get an STD if you've had unprotected sex with a new partner or if you or your sexual partner has more than 1 partner. Consider getting tested for an STD, and talk to your partner to find out if they may be at risk.[13]- If you do have an STD, you can likely get treatment to help you recover quickly.
Check the side effects of the medications you're taking. If you're taking any medication, it may be the cause of your spotting. Don't stop taking your medication without talking to your doctor. Instead, make an appointment with your doctor to ask about your medication and find out if it's causing your bleeding.[14]- In addition to birth control pills, blood thinners, antidepressants, and antipsychotics can all potentially cause bleeding between periods.
- Your doctor might tell you that your spotting is nothing to worry about. Alternatively, they may change your medication.
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Getting Medical Treatment
See your doctor if spotting recurs or if you have signs of infection. Try not to worry, but you may need medical treatment if your spotting happens often or occurs with other symptoms. Go see your doctor to find out what may be causing your spotting. Then, ask your doctor if you need to undergo treatment.[15]- Your doctor may confirm that your bleeding is normal or no cause for concern. However, you need to get an official diagnosis to be sure because some causes of abnormal bleeding can be very serious.
Get diagnostic tests to find out what's causing your abnormal bleeding. Let your doctor do a series of diagnostic tests that will be painless but may cause discomfort. Then, your doctor will make a formal diagnosis so you get treatment if you need it. Your doctor will likely do 1 or more of the following tests:[16]- A pelvic exam to look for signs of an infection, fibroids, abnormal growths, or cancer.
- Vaginal cultures to check for abnormal cells or an infection.
- Simple, painless blood tests to check for an infection or a hormone imbalance.
- Imaging tests to look for a fibroid, abnormal growths, or a problem with your reproductive system.
- An STD test to rule out these types of infections.
Tip: If you've never had your period before, your doctor might just review your medical history and do a physical exam. However, they might do a blood test, diabetes screening, thyroid screening, bleeding study, hemoglobin and platelet study, or exam under anesthesia. If you're post-menopausal, you might need a blood test, transvaginal ultrasound, or endometrial biopsy if your doctor is concerned about cancer. If you're of childbearing age, you'll likely get a pregnancy test and may need a blood test, thyroid screening, tests for liver disease, and imaging tests to look for causes of bleeding. If you're not pregnant, your doctor will likely do a complete blood count (CBC), fasting glucose, HgAIC, ultrasound, FSH/LH, thyroid test, prolactin level test, and possibly an endometrial biopsy. If you're pregnant, your doctor may do a transvaginal ultrasound or blood type test if you're in the first trimester. Later in your pregnancy, they may do a transabdominal ultrasound to locate the placenta.[17]
Call your doctor immediately if you're pregnant to be safe. You likely don't need to worry, but it's best to check with your doctor. Sometimes spotting can mean that something is wrong, but your doctor can make sure that everything is okay. Get a same day appointment with your doctor or visit the emergency room to get prompt treatment.[18]- Try not to worry because it's likely that nothing is wrong. However, it's important to make sure you and your baby are okay.
Talk to your doctor if you've been through menopause and are spotting. After menopause, you shouldn't experience any vaginal bleeding. If you do, it's possible that something is wrong. Visit your doctor to find out the cause of your spotting so you can get treatment if you need it.[19]- For instance, it's possible that you could have a hormonal imbalance or signs of cancer. However, it's also possible that your body is just having 1 last ovulation, which may not be a cause for concern.
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Expert Q&A
- QuestionI am experiencing a very heavy flow with dark red blood and large blood clots. The blood comes out like pee. Should I be concerned?
Luba Lee, FNP-BC, MSLuba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
Board-Certified Family Nurse PractitionerYes, heavy bleeding like this can be concerning. It's best to see your healthcare provider immediately to get treatment. - QuestionWhat could be causing my spotting? I’ve had an IUD for 5+ years. I've always had a period with my IUD, just a lighter one, but I’ve been spotting now daily for at least a month, maybe two months.Luba Lee, FNP-BC, MSLuba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006.
Board-Certified Family Nurse PractitionerIt's normal to have light spotting between your periods when you have an IUD, even if you've had your device for a few years. However, talk to your healthcare provider about this just to be safe.
Tips
- It's best to see your doctor if you're worried your spotting may be abnormal. It's likely everything is okay, but your doctor will put your mind at ease.Thanks
References
- ↑ https://my.clevelandclinic.org/health/articles/10132-normal-menstruation
- ↑ https://www.uofmhealth.org/health-library/abvbd
- ↑ https://www.nhs.uk/common-health-questions/womens-health/how-can-i-tell-when-i-am-ovulating/
- ↑ https://www.plannedparenthood.org/learn/birth-control/iud/iud-side-effects
- ↑ https://www.nhs.uk/common-health-questions/womens-health/what-causes-bleeding-between-periods/
- ↑ https://health.clevelandclinic.org/when-should-you-worry-about-spotting-between-periods/
- ↑ https://www.uofmhealth.org/health-library/abvbd
- ↑ https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
- ↑ https://medlineplus.gov/ency/article/007496.htm
- ↑ https://www.nhs.uk/common-health-questions/womens-health/what-causes-bleeding-between-periods/
- ↑ https://medlineplus.gov/ency/patientinstructions/000614.htm
- ↑ https://familydoctor.org/bleeding-pregnancy-whats-normal/
- ↑ https://www.uofmhealth.org/health-library/abvbd
- ↑ https://health.clevelandclinic.org/when-should-you-worry-about-spotting-between-periods/
- ↑ https://health.clevelandclinic.org/when-should-you-worry-about-spotting-between-periods/
- ↑ https://www.nhs.uk/common-health-questions/womens-health/what-causes-bleeding-between-periods/
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK470230/
- ↑ https://medlineplus.gov/ency/patientinstructions/000614.htm
- ↑ https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding
About this article
To identify abnormal vaginal spotting between periods, look for any blood outside of your normal menstrual pattern. If you notice blood, between your periods, inspect the blood to make sure it’s not discolored vaginal discharge, residue from reddish-colored urine/feces or an excreted medicinal stain, which are nothing to worry about. You should also pay attention to any other unusual symptoms that appear alongside your spotting, like an extremely low or high blood pressure, fever, fainting spells, and a sharp pain in your hips or abdomen. If you notice any of these symptoms in addition to abnormal vaginal bleeding, seek medical attention immediately. For more tips, including how to work out your normal menstrual pattern, read on!
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