Why Am I Bleeding After My Period?

Most of us have a period flow that lasts between 5 and 7 days, and though it is not the average menstrual cycle, the most commonly referenced menstrual cycle is about 28 days (counted from the first day of your last period to the first day of your next one) 

But, of course, our bodies are living beings and thus, variability is inevitable. Sometimes people who menstruate experience things like:

• Unusual or irregular cycles
• Spotting or bleeding between periods
• Longer than normal periods

Sometimes it can be difficult to tell what’s “normal” when it comes to menstrual cycles, and as a result, many people are confused by their own periods.

This is further worsened by the fact that some still find it uncomfortable to discuss these things. So, let’s try to clear up some of the confusion and help you understand why you could experience bleeding after menses.

End of Period or Something Else?

If you’re bleeding *right* after your period, it might simply be one of the lighter days at the end of your cycle and not necessarily a health concern. 

The light days at the beginning and end can manifest more as “spotting.” This can be confusing: Has your period begun? Is it ending? Or is there something else happening? The blood at the beginning and the end of a period is most often a brown color (because it is older blood). 

But, if your period has ended and you start bleeding, a good first step (before you call a health professional) is to understand if you’re bleeding or spotting.

Are You Spotting or Experiencing Vaginal Bleeding Between Periods?

Monthly periods (menses or menstrual bleeding) typically include lighter and heavier days. Some describe the lighter days at the start or end of their period as spotting. However, although it can be difficult to tell the difference, menstruation, spotting, and non-period bleeding between periods are different.

What’s the Difference?

In general, spotting is any kind of light bleeding that occurs outside of menstrual bleeding (i.e., the shedding of the lining of the uterus). While spotting has a lot of different causes (see below), it is generally lighter and does not require more than a panty liner.

If you experience heavy bleeding that is not menstrual bleeding, you should seek immediate medical care. Here’s an overview to help you tell the difference:

How to Tell the Difference Between Your Period and Spotting

What Could Cause Bleeding After a Period Ends?

There can be many explanations of vaginal bleeding between periods. Some of these are health concerns that warrant a visit to the doctor, and others are less concerning. This list is not exhaustive but includes the most common explanations for bleeding or spotting between periods (intermenstrual bleeding).

Birth Control/Hormonal Contraceptives Causes

• Birth control pills/hormonal contraceptives: According to Medical News Today, irregular bleeding between periods can occur in the first six months of taking a new birth control pill or switching between birth control pills. Doctors sometimes refer to this as breakthrough bleeding. Usually light red or reddish-brown, the blood tends to look similar to that at the start or end of a period.
• Morning-after pill: According to the Mayo Clinic, the morning-after pill can cause bleeding between periods or heavier menstrual bleeding. Spotting or light bleeding can occur up to 1 month after taking emergency contraception to prevent pregnancy. However, most people who take the morning-after pill do not experience bleeding between periods. 
• Intrauterine device (IUD): Some women with an IUD for birth control may also experience non-period bleeding. According to the American College of Obstetricians and Gynecologists, "Breakthrough bleeding happens more often with low-dose and ultra-low-dose birth control pills, the implant, and hormonal IUDs."

 Other Causes

• Trauma or medical examination: If you’ve experienced rough sex or a pelvic exam including a speculum, you may also experience vaginal bleeding.
• Medications: Certain medications may cause changes to hormone levels which cause abnormal vaginal bleeding. Your pharmacist should advise you of any side effects of medications.
• Stress: Increased stress may trigger many reactions, including breakthrough or abnormal uterine bleeding.

Common Infections

The following infections can cause spotting between periods. It’s worth noting that most infections are treatable. However, it's important to see a doctor as infections can become more serious if symptoms are ignored.

• Sexually transmitted infection (STI), including chlamydia, gonorrhea, and trichomoniasis
• Pelvic inflammatory disease (PID), an ascending infection of the upper female reproductive system

Pregnancy-Related Causes

• Ovulation: When the ovary releases a follicle—or oocyte (immature egg)—each month, this can= cause spotting for a day or so.
• Implantation bleeding: After a sperm fertilizes an egg, the fertilized egg implants in the uterus. Sometimes, implantation may cause spotting known as implantation bleeding.
• Ectopic pregnancy: Signs and symptoms of an ectopic pregnancy include abdominal pain, vaginal bleeding and a positive pregnancy test.
• 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 breastfeeding frequency and your hormone levels, spotting may occur before full periods return.

Other Causes

• Fibroids or polyps: Symptoms of these benign tumors can include irregular or heavy periods and heavy bleeding between periods.
• Endometriosis: According to the Mayo Clinic, women with endometriosis may experience occasional heavy menstrual periods and bleeding or spotting between periods (intermenstrual bleeding).
• Polycystic ovary syndrome (PCOS): PCOS is a syndrome associated with abnormal ovulation that can sometimes make it difficult to get pregnant. It can also cause abnormal bleeding, including irregular menstrual periods or none at all.
• Blood clotting disorders like von Willebrand disease—which affects the blood's ability to clot—can result in bleeding between periods. Warning signs include heavy bleeding after injury, frequent, prolonged nosebleeds, or routine procedures such as dental work.
• Other health conditions, like hypothyroidism, liver disease, or chronic kidney disease, can cause non-period bleeding.
• Cancer: Cancer or precancer 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 considerably. 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: As vaginal mucosa gets thinner due to lack of estrogen after menopause, it is also more vulnerable to irritation which 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: Signs & Symptoms

If experiencing persistent spotting or heavy bleeding outside of your period and/or your bleeding is accompanied by any of the following symptoms, it warrants getting some medical advice from your doctor or a qualified health professional. Heavy vaginal or uterine bleeding may increase the risk of other conditions such as anemia, which can negatively impact your health, so it’s wise to closely monitor how much you’re bleeding.

Keep track of the number of pads or tampons used and saturated when you’re bleeding. Abnormal blood loss can be estimated by tracking the number of pads or tampons used and how quickly they become soaked. Soaking a pad or a tampon within 1 hour indicates heavy menstrual or uterine bleeding at a concerning rate.

When to See Your Doctor

If any of the following symptoms accompany irregular vaginal or uterine bleeding, it warrants a trip to the doctor:

• Heavy periods with blood clots greater than a quarter-size
• Irregular periods
• Abdominal pain or cramping
• Pain or a burning sensation when peeing
• Abnormal vaginal discharge and/or redness, irritation, or itchiness of the vagina or external genitalia (vulva).

You may also want to read our article: Why am I passing blood clots between periods

Don't Ignore Abnormal Vaginal Bleeding or Abnormal Uterine Bleeding in These Cases

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 seems to happen frequently and randomly, you should look into it.
• It begins after unprotected sex: Unprotected sex can put you at risk for STIs and other kinds of infection. If you notice spotting after unprotected sex, it’s wise to visit a doctor or qualified health professional.
• If you are on medication that may also cause abnormal uterine 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.

Questions the Doctor Might Ask

It’s very natural to be nervous about seeking medical advice. But it’s also smart to remember that a doctor may be able to quickly resolve a concern that’s causing you much stress and many sleepless nights, especially if they have all of the information that they need.

So, if there’s anything about your cycle that’s causing you concern (like abnormal uterine bleeding), we recommend biting the bullet and booking that doctor’s appointment.

Be Prepared to Discuss These Topics

When you see your doctor, they may need to know:

• How long this has been happening: Is it something you’ve always experienced, or did it start recently etc.
• How often does it happen: 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 on 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 better or worse?

Based on your answers, the doctor may need to perform certain tests. Treatment, management and recommendations will always depend on the cause. But you’ll have taken a step in the right direction by seeking medical advice.

Medically reviewed by Dr. Chimsom T. Oleka, M.D, Written by Jane Flanagan — Updated on November 1, 2021.

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, and in period underwear.