What’s the Difference Between Spotting and Bleeding?

TEAM KNIX / YOUR BODY

The term “spotting” is confusing for many of us. We may think the light days of our period are spotting. Or we may wonder what the difference between spotting and a period really is.

Some people, even medical professionals use the term “spotting” inconsistently, which doesn’t help.

So let’s help clear up the confusion!

Spotting vs. Menstruation

Periods typically have lighter and heavier days. Many women describe those lighter days at the start or end of their period as spotting. However, although it can be difficult to tell the difference, menstruation and spotting are different.

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:

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Period

Spotting

Schedule

Usually monthly

Irregular, but may coincide with ovulation for some

Duration

Usually 5-7 days

No consistent pattern.

Bleeding Pattern

Different for every woman, but usually starts light, gets heavier for 2-3 days and gradually tapers off

No consistent pattern.

Blood Color

Usually red. May include clotting, which is less common with spotting.

Can be a different color than period blood. Many women spot brown blood.

Source of Blood

Uterus: Periods are the cyclical shedding of your uterine lining

Spotting can come from your upper reproductive tract (like your uterus) or your lower reproductive tract (like your cervix or vagina). 

Other Symptoms

Hormone changes trigger other symptoms, including breast tenderness, bloating and cramping.

Depends on the cause of the spotting.

Management

Most women use period products like tampons, pads etc.

Does not usually require a period product. Panty liner or leakproof underwear will usually suffice.


Menstrual Bleeding

Menstrual bleeding has some notable characteristics. The most obvious one is that it happens for most women on a monthly schedule—roughly every 28 days in non-pregnant women. 

Every month, the uterine lining thickens to prepare for pregnancy. If impregnation does not occur, the uterus sheds its lining. This shedding is what we call a period or menses.

Periods are also often consistently accompanied by other symptoms. These can include bloating, breast tenderness, but those symptoms are different for every woman.

Spotting

Spotting is any light bleeding between periods. There can be many causes of spotting, 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 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.

How to Tell Whether You’re Spotting or Menstruating

If you’re at a reproductive age, you experience a monthly period. The easiest way to tell if your bleeding is spotting or menstruating is to keep track of your monthly periods.

Some women experience less regular periods, but keeping a diary of when periods occur will help you understand your own individual cycle.

Use the diary to track your periods, including symptoms you may experience in the days before your period. These might include tender breasts, bloating, headaches or PMS. 

Becoming familiar with your menstrual cycle and the characteristics of your own individual period will help you be more confident in identifying unusual bleeding.

If you experience non-menstrual bleeding, don’t panic. Spotting does not always mean that there’s something wrong. Spotting can result from a variety of causes and some are non-harmful (e.g. ovulation or implantation bleeding), while others are potentially concerning.

Common Causes of Spotting

Ovulation

When the ovaries release the egg, a tiny follicle ruptures to allow the egg to be released. This can be a cause of spotting for a day or so.

For some women, spotting that occurs around the time of ovulation is light red or pink in color. This is because we also produce more cervical fluid around the time of ovulation and the blood gets mixed with that fluid, causing it to be a lighter shade.

Implantation

After a sperm fertilizes an egg, the egg implants in the womb. This is an early step of pregnancy, known as implantation. Sometimes, implantation causes light spotting known as implantation bleeding.

Implantation bleeding typically only lasts 1-2 days and is most likely to occur about a week after ovulation. Some women will mistake implantation bleeding for their period and do not realize that they are actually pregnant. 

Pregnancy

According to the American Pregnancy Association, 20% of women experience spotting during the first 12 weeks of being pregnant. 

Although any unusual bleeding might be a frightening experience for a pregnant woman, light spotting (a few drops of blood on your underwear, or on tissue when using the toilet) is not usually a cause for concern.

Apart from implantation bleeding, there can be a few causes of bleeding during a pregnancy. Because there is an increased number of blood vessels in the tissue around the cervix, sex, gynaecological exams or heavy lifting can all cause spotting.

If you experience spotting during your pregnancy, contact your healthcare provider for reassurance.

Miscarriage 

A miscarriage, or spontaneous abortion, is an event that results in the loss of a fetus before 20 weeks of pregnancy. It typically happens during the first trimester, or first three months, of the pregnancy.

Heavy spotting is one of the symptoms of miscarriage. So it’s important you discuss any spotting during pregnancy with your healthcare provider.

In some cases, a miscarriage can happen so early that women mistake it for a particularly heavy pregnancy and don’t realize they were pregnant.

Ectopic Pregnancy

Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the womb or uterus, most commonly in the Fallopian tubes. 

Signs and symptoms of an ectopic pregnancy include abdominal pain and vaginal bleeding.

Breastfeeding

Almost all breastfeeding new mothers are menstruation-free for about 6 months postpartum. This is known as lactational amenorrhea.

What happens is that your baby’s nursing inhibits the hormones that kickstart a menstrual cycle. No hormones means no ovulation which means no period.

Amenorrhea is unique to each and every breastfeeding mother and we all have different body chemistry and sensitivity to our own hormonal fluctuations. 

Depending on the frequency of breastfeeding and your own individual hormones, spotting may occur before full periods return. The hormonal changes that occur as the body prepares to ovulate for the first time after childbirth may also trigger spotting.

Uterine Fibroids or Polyps

Uterine fibroids are benign, noncancerous growths in the uterus. While they are not usually harmful, they can grow quite large, which can cause discomfort.

Women with fibroids or polyps can experience spotting between periods. Their period may also be affected by these growths, becoming heavier.

Your doctor will usually palpate (gently press and examine) your abdominal area to check for such growths at an annual check-up. If she is concerned, she may order a scan.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. 

PCOS can cause cysts in the ovaries and make it difficult to get pregnant. It can also cause irregular bleeding or spotting.

Birth Control / Contraception

Some birth control methods can cause spotting. According to Medical News Today, spotting often occurs in the first 6 months of taking a new birth control pill. Doctors sometimes refer to this as breakthrough bleeding.

Other birth control methods can also cause spotting. Some women with an IUD (intrauterine device) for birth control experience spotting. 

Be sure to check with your healthcare provider all the possible risks and side effects of any birth control or contraceptive.

Injuries / Trauma

Any kind of injury or trauma, including assault or rough sex, can result in vaginal tearing which can cause spotting to occur.

Standard medical procedures, like a PAP test, can also result in spotting.

If the spotting is light and unaccompanied by pain, it will usually go away on its own. However, if you’re experiencing pain or the bleeding is heavy, seek out medical support.

Infection

Sexually Transmitted Diseases (STI’s) and other infections like Pelvic Inflammatory Disease (PID) can all be causes of spotting. 

Most infections are treatable. But infections can become more serious if ignored, so it’s worth getting routinely tested for STIs.

Perimenopause

Most women experience menopause between the ages of 45 and 55. This is when menstrual cycles cease.

The time before menopause is known as perimenopause and it can last between one and 10 years. During this time (as with adolescence and pregnancy) hormones fluctuate greatly.

These hormonal shifts can have an effect on ovulation and your entire menstrual cycle. You may notice irregular or skipped periods and spotting between periods during perimenopause. 

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.

“Any post-menopausal bleeding should warrant a visit to a gynecologist,” says Ursula Matulonis, MD, chief of the Division of Gynecologic Oncology at Dana-Farber Cancer Institute.

Should You Be Concerned About Spotting? 

If you experience continuous spotting or abnormal vaginal bleeding you should see your doctor or other healthcare professional.

In particular, spotting that is accompanied by any of the following warrants a trip to the doctor:

  • Heavy periods with a lot of clotting
  • Irregular periods
  • Spotting accompanied by 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 ignore spotting in the following situations:

  • If you think you’re pregnant: You should always see a doctor as soon as you think you might be pregnant to be administered a pregnancy test.
  • When spotting happens inconsistently: If spotting seems to happen frequently and randomly, you should definitely look into it.
  • Spotting 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.
  • If you’re stressed by spotting: If spotting is making you nervous, seek our reassurance from your healthcare provider. Even if there’s no cause for concern, you can stop losing sleep.
  • You are on medication that may cause spotting: 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 women post-menopause to experience spotting or vaginal bleeding.