Reasons You Might Be Spotting 2 Weeks After Your Period

This article was medically reviewed by Dr. Navya Mysore and updated on March 8, 2024

Most of us have a menstrual cycle that lasts on average 28 days, which means we have (roughly) monthly periods. The first day of your menstrual cycle is counted from the first day of your period.

If you’re bleeding 20 days after your last period, it could be that you have a shorter menstrual cycle. Or, it could be non-period bleeding (i.e., bleeding between periods). Read on to learn more or check out "Why am I bleeding 2 weeks after my last period?" article

What Is Spotting? 

In general, spotting refers to occasional, light vaginal bleeding that occurs outside of regular periods. It does not usually require menstrual products beyond a panty liner. Spotting is typically lighter than a regular period and may last anywhere between a few hours and a few days. Spotting in between periods is not the same as an irregular period, though some women may find them difficult to tell apart.

How to Tell the Difference Between Your Period and Spotting

Here’s an overview to help you tell the difference between your menstrual period and non-menstrual vaginal bleeding—or spotting—between periods.

Spotting is any light bleeding between periods (not to be confused with irregular menstrual cycles.) There can be many causes of spotting, some totally safe and some that are more concerning.

While unexplained spotting can be irregular, spotting that is caused by events in the menstrual cycle, like ovulation, may occur regularly. 

Spotting blood can have a different hue than period blood. It might be brown and it can also appear more like vaginal discharge. 

Finally, most spotting is light: A panty liner or period underwear is usually sufficient to handle the bleeding caused by spotting. 

If you experience heavy bleeding outside a menstrual period, or experience consistent irregular spotting in between periods, you should consult a medical professional to find out the underlying cause.

The Likeliest Cause of Abnormal Uterine Bleeding

You ovulate on about day 14 of your cycle. For many women, the days around ovulation go completely unnoticed. But for some, ovulation is an event where they may notice light spotting, mild cramping, breast tenderness or thicker vaginal discharge. 

During reproductive ages, the ovary releases an oocyte (immature egg) every month. This event occurs when ovary follicles rupture and release the oocyte, which travels to the fallopian tube and becomes an ovum or egg. The rupture of the ovary follicles can cause some light spotting and some experience light cramping. 

Ovulation Pain

Ovulation pain manifests as a slight twinge or pain on one or both sides of your abdomen. This pain is called ovulation pain, or mittelschmerz. It translates literally as “middle pain” and is the name for the slight twinge or cramp that some women experience when the follicle releases the oocyte.

"Ovulation pain is not harmful. Most of the time, you can treat it with (over-the-counter) medications, rest, and warm baths," according to the Cleveland Clinic.

The best way to understand whether bleeding corresponds with ovulation is to track your periods and spotting using an app or diary. You can also crosscheck that you are ovulating by using ovulation strips so you can confirm the spotting is due to ovulation. If bleeding occurs and it does not coincide with ovulation, there may be many other possible causes.

Below is a list of the most common reasons (outside of ovulation bleeding) that you might be bleeding or spotting between periods. While this list is not exhaustive, it does cover the most likely explanations of bleeding between periods.

Other Causes of Abnormal Vaginal Bleeding After a Period

The truth is, there are many possible explanations of spotting between periods (including breakthrough bleeding associated with birth control pills and ectopic pregnancy). Some of these, you’ll be able to rule out on your own (e.g., if you’re not on medication or know you're not pregnant). But, when in doubt, check in with your doctor to review your symptoms.

Here are the most common causes of spotting between periods:

Birth Control & Breakthrough Bleeding

• Birth control pills (hormonal contraceptives): According to Medical News Today, bleeding between periods often occurs in the first 6 months of taking a new birth control pill (a.k.a. hormonal contraceptive pills, oral contraceptives, the contraceptive pill or simply "the pill"). Doctors sometimes refer to this light vaginal bleeding as breakthrough bleeding.
• Morning-after pill: According to the Mayo Clinic, the morning-after pill (emergency contraception) can cause vaginal bleeding between periods or heavier menstrual bleeding as it causes fluctuations in hormone levels.
• Intrauterine device (IUD): Some women with an IUD for birth control (like other forms of hormonal contraception) may also experience spotting at the time of their period and/or spotting in between cycles.

External Causes of Vaginal/Uterine Bleeding

• Trauma or medical examination: If you’ve experienced rough sex or a medical exam like a Pap test, you may also experience vaginal bleeding.
• Medications: Certain medications (other than hormonal contraceptives) may cause abnormal vaginal bleeding. Your pharmacist or other healthcare professional should advise you of any side effects of medication, including unusual vaginal bleeding.
• Stress: Increased stress may trigger many reactions. Stress may cause all kinds of changes in your body, including menstrual irregularities. Some may experience vaginal spotting or bleeding between periods due to high levels of emotional stress.

Common Infections, Including Sexually Transmitted Infections

The following infections may cause irregular bleeding between periods. It’s worth noting that most infections are treatable. However, infections can become more serious if symptoms are ignored. If you are experiencing any abnormal symptoms out of the ordinary like different vaginal discharge, pelvic pain, urinary symptoms, it’s probably best to check-in with your doctor.

• Sexually transmitted infection (STI), including chlamydia, gonorrhea, and genital warts
• Pelvic inflammatory disease (PID), an infection of the upper part of the female reproductive system that typically occurs due to an STI that has gone untreated
• Urinary tract infection (UTI): A urinary tract infection (UTI) may cause spotting, although it is not a common symptom. However, sometimes a UTI may irritate the lining of the urethra or bladder, causing small amounts of blood to appear in the urine. If you are having urinary symptoms like burning and there is blood in the urine, be sure to see your doctor right away. 

Pregnancy-Related Causes of Bleeding Between Periods

• Implantation bleeding: After a sperm fertilizes an egg, the fertilized egg implants in the womb. Sometimes, implantation of the fertilized egg in the uterus causes light bleeding known as implantation bleeding. Some women don't experience it and others do. Implantation bleeding is light, stops on its own, and doesn't require treatment.
• Ectopic pregnancy: In an ectopic pregnancy, the fertilized egg implants in a location outside the uterus, usually in the fallopian tube. Ectopic pregnancies cannot be carried to term. Signs and symptoms of an ectopic pregnancy include abdominal pain and vaginal bleeding, and requires prompt medical attention.
• Pregnancy: According to the American Pregnancy Association, 20% of women experience spotting during the first 12 weeks of being pregnant.
• Miscarriage: Sometimes with a miscarriage you may not have heavy bleeding but can have spotting and cessation of other pregnancy symptoms.
• Breastfeeding: Depending on the frequency of breastfeeding and your own individual hormone levels, spotting may occur before your full period returns.

Other Causes of Unusual Vaginal Bleeding

• Uterine fibroids or polyps: Symptoms and signs of these benign tumors in the uterus or reproductive organs can include irregular or heavy periods and vaginal bleeding between periods. How your doctor will treat fibroids (or other abnormal growth) will depend on the size, number, location, and symptoms of the fibroids.
• Endometriosis: According to the Mayo Clinic, women who have endometriosis may experience heavy menstrual periods or irregular vaginal bleeding between periods (intermenstrual bleeding).
• Polycystic ovary syndrome (PCOS): Polycystic ovary syndrome can cause cysts in the ovaries and could affect fertility. It can also cause irregular vaginal bleeding.
• Blood clotting disorders, like von Willebrand disease, can cause bleeding between periods.
• Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease can cause irregular vaginal bleeding.
• Cancer or precancer: Cervical cancer, uterine cancer can cause spotting or abnormal bleeding.

Perimenopause & Menopausal Causes of Bleeding Between Periods

• Perimenopause: The time before menopause is known as perimenopause. During perimenopause, hormone levels fluctuate greatly. These hormonal imbalances can have an effect on ovulation. Some notice irregular or skipped periods and abnormal bleeding between periods during perimenopause due to hormonal changes (particularly a drop in estrogen levels.)
• Vaginal dryness, especially due to lack of estrogen in menopause, vaginal dryness can cause bleeding.

When to See Your Healthcare Provider

Many of us avoid consulting medical professionals about menstrual or intermenstrual concerns. However, if your bleeding pattern continues for a few cycles, it’s worth bringing up with your medical provider. 

If there’s nothing to worry about and it's normal vaginal bleeding, they’ll be able to set your mind at ease. However, there are times when spotting, breakthrough bleeding, or other bleeding between periods could be a cause for concern. And if that’s the case, the sooner you see your healthcare provider, the better.

If spotting is accompanied by any of the following symptoms, you should definitely seek medical advice:

• Heavy periods with a lot of clotting
• Irregular periods
• Abdominal pain or cramping
• Pain or a burning sensation when urinating
• Unusual vaginal discharge and/or redness and itchiness

Sources:

https://my.clevelandclinic.org/health/diseases/9134-ovulation-pain-mittelschmerz

https://www.medicalnewstoday.com/articles/322840#causes

https://www.mayoclinic.org/tests-procedures/morning-after-pill/about/pac-20394730

https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088

https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/spotting-during-pregnancy/

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

https://www.mayoclinic.org/diseases-conditions/von-willebrand-disease/symptoms-causes/syc-20354978 

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We hope you found this post informative—but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition. 

We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.