If you experience spotting after your period ends, you may think your monthly period has come again (too soon!) Or you may wonder if your period even ended.
But there is a difference between your monthly period and other vaginal bleeding. If spotting occurs, there could be a number of possible explanations. Some of these are no cause for concern and others require consulting a medical professional.
Read on to learn more...
What is Spotting?
In general, spotting is any kind of light bleeding that is not having a period. We’ll go through some of the different characteristics of menstrual bleeding versus spotting.
Here’s an overview to help you tell the difference:
Spotting is any light bleeding between your period. There can be many causes of spotting between periods, some totally safe and some that are concerning. As such, spotting doesn’t usually follow any pattern.
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 discharge or blood and it can also have a different texture.
Finally, most spotting is light: A panty liner or leakproof underwear is usually sufficient to handle the bleeding caused by spotting.
If you experience heavy bleeding outside a period that requires more than a panty liner, you should consult a medical professional.
What Could Cause Spotting After Your Period?
The truth is there are many possible explanations of bleeding between periods. 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 others will require a doctor’s visit to test for and rule out.
This list is not exhaustive, but these are the most common causes of bleeding between periods.
Birth Control & Hormonal Contraceptives
- Hormonal Contraceptives & Birth Control Pills: According to Medical News Today, bleeding between periods often occurs in the first 6 months of taking a new birth control pill. Doctors sometimes refer to this as breakthrough bleeding.
- Morning-After Pill: According to the Mayo Clinic, the morning-after pill can cause bleeding between periods or heavier menstrual bleeding.
- Intrauterine Device (IUD): Some women with an IUD for birth control may also experience non-period bleeding or breakthrough 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 may cause abnormal vaginal bleeding. Your pharmacist should advise you of any side-effects of medication.
- Stress: Increased stress may trigger many reactions. Stress may cause all kinds of changes in your body, including irregularities in your menstrual cycle. Some may experience vaginal spotting due to high levels of emotional stress.
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.
- 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.
- Ovulation: When the ovaries release the egg, a tiny follicle ruptures to allow the egg to be released. This can be a cause of bleeding for a day or so.
- Implantation bleeding: After a sperm fertilizes an egg, the fertilized egg implants in the womb. Sometimes, implantation causes light bleeding known as implantation bleeding.
- Ectopic Pregnancy: Signs and symptoms of an ectopic pregnancy include abdominal pain and vaginal bleeding.
- Pregnancy: According to the American Pregnancy Association, 20% of women experience spotting during the first 12 weeks of being pregnant.
- Miscarriage: Heavy spotting is one of the symptoms of miscarriage.
- Breastfeeding: Depending on the frequency of breastfeeding and your own individual hormone levels, spotting may occur before full periods return.
- Uterine fibroids or Polyps: Symptoms of these benign tumours can include irregular or heavy periods and vaginal bleeding between periods.
- Endometriosis: According to the Mayo Clinic, women with endometriosis may experience occasional heavy menstrual periods or irregular bleeding between periods (intermenstrual bleeding).
- Polycystic ovary syndrome (PCOS): PCOS can cause cysts in the ovaries and make it difficult to get pregnant. It can also cause irregular vaginal bleeding.
- Blood clotting disorders, like von Willebrand disease.
- Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease.
- Cancer: Cancer or pre-cancer of the cervix, uterus, or (very rarely) fallopian tube can cause spotting or abnormal bleeding.
Perimenopause & Menopause
- Perimenopause: The time before menopause is known as perimenopause. During perimenopause, hormone levels fluctuate greatly. These hormonal shifts can have an effect on ovulation and your entire menstrual cycle. Some notice irregular or skipped periods and abnormal bleeding between periods during perimenopause.
- Vaginal dryness, especially due to lack of estrogen after menopause, can cause bleeding.
- Cancer: According to the Dana-Farber Cancer Institute, spotting in post-menopausal women can, in some cases, be an early sign of cancer and should always be investigated further.
When to Seek Medical Advice
Many of us avoid consulting medical professionals about menstrual or intermenstrual concerns. However, if you’re experiencing stress or anxiety due to uncertainty it’s always worth talking to your healthcare provider.
If there’s nothing to worry about, they’ll be able to set your mind at ease. However, there are times when spotting or bleeding between periods could be a cause for concern. And if that’s the case, the sooner you see a doctor, the better.
If spotting is accompanied by any of the following symptoms, it warrants getting some medical advice.
- Heavy periods with a lot of clotting
- Irregular periods
- Abdominal pain or cramping
- Pain or a burning sensation when peeing
- Unusual vaginal discharge and/or redness and itchiness
Even if you don’t have any of the above symptoms, don’t ever ignore spotting, abnormal vaginal bleeding or abnormal uterine bleeding in the following situations:
- If you think you’re pregnant: You should always see a doctor as soon as you think you may be pregnant to be administered a pregnancy test.
- When it happens inconsistently: If spotting seems to happen frequently and randomly, you should definitely look into it.
- It begins after unprotected sex: Unprotected sex can put you at risk for STI’s and other infections so if you notice spotting after unprotected sex, it’s wise to visit a doctor.
- You are on medication: If spotting can be a side-effect of any medication you are on, you should seek out professional help.
- Spotting occurs post-menopause: It is never considered normal for anybody post-menopause to experience spotting or vaginal bleeding.
What to Expect at Your Doctor’s Visit
When you see your doctor, she will want to know:
- How long this has been happening: Is it something you’ve always experienced or did it start recently etc.
- How often it happens: Is it monthly or irregular? Is this the first time it’s happened?
- If there’s a pattern to the bleeding: Have you observed the spotting happens certain days in your menstrual cycle or seemingly at random?
- How long did the spotting last: 1-2 days or more?
- How heavy was the bleeding: Did you use any protection? Was a panty liner insufficient?
- Was there anything unusual about the blood: Color, texture or odor?
- Did you also experience pain while you were bleeding?
- Did the bleeding coincide with any increased physical exertion (sex, exercise etc.)?
- Was there anything you did that seemed to make the spotting worse or better?
She will also likely examine you. The tests she might administer will depend on your age and other factors. If you could be pregnant, she’ll probably administer a pregnancy test.
She’ll also likely order bloodwork to check your blood count and see if you’re anemic.
Other tests may include:
- Endometrial biopsy: An endometrial biopsy is used to screen for abnormal cells in the uterus. Learn more from Johns Hopkins Medicine.
- Hysteroscopy: A hysteroscopy allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Learn more from The Cleveland Clinic.
- Pelvic Ultrasound: A pelvic ultrasound allows quick visualization of the female pelvic organs and structures including the uterus, cervix, vagina, fallopian tubes and ovaries. Learn more from Johns Hopkins Medicine.
It can cause anxiety and stress when you start bleeding without explanation. However, as we’ve seen a number of different things could cause spotting.
If this is happening to you, don’t jump to the worst possible conclusion. Track what’s happening and decide if you need to seek medical advice.
Although many of us experience anxiety about the thought of a doctor’s visit, it might be the easiest way of finding reassurance. If there is something to be concerned about, you’ll be glad you acted sooner.