Spotting After Period? Here’s What You Need to Know

You think your period is over and all of a sudden there’s blood on your underwear or toilet paper. What gives? We’re so used to blood meaning menstruation that the first conclusion most will jump to is that their period has gone a little haywire. 

But vaginal bleeding isn’t always explained by a menstrual period. In fact, there can be many reasons you might experience spotting or bleeding between periods. Some of these are easily explained (and, if necessary, treated). Others are a little more complex to understand.

No unexplained bleeding is a nice experience—from any part of your body. And abnormal vaginal bleeding is no exception. But don’t panic. Most people experience spotting at some point in their lives, and some women experience it often.

Let’s unpack what might be going on...

Spotting or Period: What’s the Difference?

Your monthly period is, most likely, a familiar and regular occurrence. Over time, most women understand the rhythm and pattern of their cycle, and the characteristics of bleeding that occur over the 5–7 days of their normal period.

Spotting doesn’t necessarily follow any such pattern. The source of bleeding can also varied: 

Spotting can come from your uterus, cervix, or vagina. It’s considered different from your period (the monthly shedding of your uterine lining, your endometrium).

Unusual bleeding between periods can be called spotting, intermenstrual bleeding, and metrorrhagia. 

Here’s an overview to help you tell the difference between your period and spotting:

What Causes Spotting During the Menstrual Cycle? 

The truth is there are many possible explanations of bleeding between periods. You'll see some that are not applicable to you and you can rule out on your own (e.g., if you’re not on medication or know you're not pregnant). But other common symptoms will require a visit to your healthcare provider to test and rule out.

This list is not exhaustive, but these are the most common causes of bleeding between periods.

Birth Control Causes for Abnormal Uterine Bleeding

• Birth control pills: According to Medical News Today, bleeding often occurs in the first 6 months of taking a new birth control pill. Doctors sometimes refer to this light bleeding as breakthrough bleeding.
• Morning-after pill: According to the Mayo Clinic, the morning-after pill can cause spotting between periods or heavier menstrual bleeding.
• Intrauterine device (IUD): Some individuals with an IUD for birth control may notice non-period bleeding occurs.

External Causes for Abnormal Vaginal Bleeding

• Trauma or medical examination: If you’ve experienced rough sex or a medical exam like a Pap smear, you may experience vaginal bleeding.
• Medications: Certain medications may cause abnormal vaginal bleeding (not just the breakthrough bleeding that can happen when you start new birth control pills and other hormonal contraceptives). Your pharmacist should advise you of any side effects of medication.
• Stress: Stress can trigger many reactions, including spotting.

Common Infections

The following infections can cause spotting between periods. It’s worth noting that most infections are treatable. However, infections can become more serious if ignored.

• Sexually transmitted infections (STIs), including chlamydia, gonorrhea, and genital warts
• Pelvic inflammatory disease (PID), an infection of the upper part of the female reproductive system

Pregnancy-Related Causes

• Ovulation: When the ovaries release the oocyte (immature egg), a tiny follicle ruptures to allow it to be released. This can be a cause of bleeding or bloody discharge 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 hormones, spotting may occur before full periods return.

Other Causes

• Fibroids or polyps: These benign tumors can cause 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 bleeding between periods (intermenstrual bleeding).
• Polycystic ovary syndrome (PCOS): Polycystic ovary syndrome 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 can cause menstrual disorders.
• Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease can interrupt normal periods.
• Cancer or precancer: Cervical cancer, uterine cancer, or (very rarely) fallopian tube cancer can cause spotting or abnormal bleeding.

Perimenopause & Menopause

• Perimenopause: The time before menopause is known as perimenopause. During perimenopause, hormones fluctuate greatly. These hormonal shifts can have an effect on ovulation and your entire menstrual cycle. Some women 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. According to the Cleveland Clinic, "Vaginal dryness is a symptom of many different medical conditions. It can cause pain during sitting, standing, exercising, urinating (peeing), and sexual intercourse."
• Cancer: According to the Dana-Farber Cancer Institute, spotting in postmenopausal women can, in some cases, be an early sign of cancer and should always be investigated further by a medical doctor.

How Serious Is Spotting: When to See Your Doctor

Keep track of the number of pads or tampons used when you’re spotting. Abnormal blood loss can be estimated by tracking the number of pads or tampons used and how quickly they become soaked.

If you’re taking pain medications, aspirin should be avoided, as it may prolong bleeding. 

If irregular bleeding is is accompanied by any of the following symptoms, it warrants a trip to the doctor:

• 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 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 between periods 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 STIs and other infections. So, if you notice spotting after unprotected sex, it’s wise to visit a doctor.
• You are on medication that may also cause bleeding: If spotting can be a side effect of any medication you are on, you should seek out professional help.
• Spotting occurs postmenopause: It is never considered normal for anybody postmenopause to experience spotting or vaginal bleeding. 

Diagnosis: What to Expect

Seeking medical advice can be hard: Many of us dread a visit to the doctor. We imagine the news will be terrible. And so we subject ourselves to all kinds of anxiety and uncertainty instead of simply seeking reassurance or an explanation of the underlying cause.

So, if you’re experiencing unusual bleeding and you know it’s time to bite the bullet and go to see your healthcare professional, here are some questions you can prepare yourself to answer.

When you see a medical professional, they 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 that the bleeding happens on certain days in your menstrual cycle or is it seemingly at random?
• How long did the bleeding 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?

Based on your answers, the doctor might also perform certain tests, etc. Treatment and outlook will always depend on the cause. 

Whenever you seek medical advice, you'll generally feel relieved afterwards for having taken action.

Written by Jane Flanagan — Updated on April 5, 2022.

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.