What is spotting and why does it happen?
Common causes of spotting, how to track it, and how it differs from other types of bleeding during your cycle.
Top things to know:
Spotting is any bloody vaginal discharge that doesn’t require the use of period products, like a pad or tampon.
Any unexplained spotting should be addressed with your healthcare provider.
Spotting can be a side effect of your hormonal contraceptive.
If you’re pregnant and spotting or bleeding, you should contact your healthcare provider.
What is the difference between your period, spotting, and intermenstrual bleeding?
The lines between menstrual bleeding (i.e. your period), spotting, and intermenstrual bleeding can get kind of confusing, and you may have read a lot of conflicting information.
Menstrual bleeding is bleeding that is associated with the shedding of the endometrium at the end of the menstrual cycle (1). It typically occurs every 24 to 38 days and lasts up to eight days (1).
Spontaneous bleeding (heavy enough that you need to use a pad or tampon) that occurs between menstrual periods is called intermenstrual bleeding and can be cyclical or random (1). If you experience intermenstrual bleeding, you should speak to your healthcare provider as this may be a sign of an underlying condition (1).
You can track intermenstrual bleeding with a custom tag in Clue. To create a custom tag, go to ‘Track’ then select ‘Tags’. Get Clue Plus to track multiple custom tags.
Spotting has different definitions, depending on who you ask.
So what is spotting?
Researchers and healthcare providers define spotting as any bloody vaginal discharge that is not of a large enough volume to require sanitary protection (i.e. you don’t need to use a pad or a tampon) (2).
However, this definition can be confusing. Some people may choose to use panty liners when spotting. However, if you soak a panty liner, or need to use a pad or a tampon, then that likely isn’t spotting.
In theory, spotting can happen at any time during your cycle, so around your period or between periods.
How does spotting differ from light period bleeding?
The most practical way to differentiate spotting from menstrual bleeding is by looking at the amount.
Spotting refers to a very small amount of bloody vaginal discharge that is usually seen as a few drops of blood on the underwear or toilet paper (2).
Light bleeding, on the other hand, is a slightly heavier form of bleeding than spotting. It typically requires the use of menstrual products, like a tampon or pad or a higher absorbency panty liner (2).
Generally, if you have light bleeding that occurs at the beginning of your period, you should consider that part of your period, not spotting. However, if it’s very, very light—you only see a little on your toilet paper—that would be considered spotting.
For example, if you have spotting on Sunday, no bleeding on Monday, and bleed enough to require a tampon on Tuesday, you should consider Tuesday the start of your period.
Tracking tip: What if you initially logged spotting in the morning and then it turns into your period in the afternoon? No problem, you can always go back and change what you tracked. It’s important that the first day of your period is recorded correctly in order to provide more accurate predictions for your next cycle.
How to track bleeding in the Clue app
If you track period bleeding and it’s been more than 10 days since you last tracked your period, that day will be counted as the first day of a new menstrual cycle.
When tracking your period in Clue, there are four tracking options: light, medium, heavy, and super heavy.
In Clue, there are two tracking options for spotting: red and brown.
Blood changes color depending on how long it has been exposed to air, due to a process called oxidation (if you cut your finger you’ll notice the blood is bright red, but then it looks brown on the band-aid later—that same process can happen to menstrual blood as it moves out of your body). Fresh blood often appears red (or pink if mixed with other fluid), while older blood tends to look brown.
What is the source of spotting?
Spotting can come from your upper reproductive tract (like your uterus) or your lower reproductive tract (like your cervix or vagina) (2).
Common causes of spotting
1. Hormonal contraception
Spotting is a common side effect of hormonal contraception, especially during the first few months of starting a new method (3).
When you first start taking combined oral contraceptives (the most common type of birth control pill), you may experience spotting that goes away after a couple of months (3). The most common reason for spotting is missed or late pills (2,3). Bleeding or spotting outside of your usual withdrawal bleed time can sometimes happen even if you take your pills continuously (3). Any bleeding you experience outside of your expected withdrawal bleed time while taking the pill is called non-scheduled bleeding (sometimes also called breakthrough bleeding) (2,3). If you continue to experience non-scheduled bleeding, your pill may not be the best fit for you, and your healthcare provider may suggest you try another brand with a different chemical formation (3).
If you’re on the pill, you can track non-scheduled bleeding in the Clue app by creating a custom tag.
Spotting and unpredictable bleeding are both common with the hormonal IUD, the contraceptive implant, the contraceptive shot (injection), and the mini-pill (a progestin-only pill), and typically improves over time (2,3).
Spotting is also a common symptom of early pregnancy. About 1 in 4 people experience spotting, usually between gestational weeks 5 and 8 (or about 1 to 4 weeks after someone expects their period) (4). Spotting is usually nothing to worry about—research has shown that people with spotting aren’t more likely to have a miscarriage than people who don’t have spotting (4). However, heavy spotting or bleeding may be more of a concern. If you’re pregnant and bleeding, call your healthcare provider to check in, just so they know what’s going on.
While many sources call spotting in early pregnancy “implantation bleeding,” there isn’t strong evidence that it’s associated with an embryo’s implantation in the uterus. It may actually be related to hormonal changes, as the production of progesterone switches from the ovary to the forming placenta (4).
Spotting can be a symptom of an ectopic pregnancy (5). This is a pregnancy that is growing somewhere other than the uterus, usually the fallopian tube (5). Ectopic pregnancy bleeding may be coupled with other symptoms including abdominal pain on one side, shoulder pain, and/or dizziness (5). If you experience symptoms of spotting and suspect you may have an ectopic pregnancy, seek immediate medical help.
3. Physical conditions and infections
Spotting can also be caused by infections and physical changes in the reproductive tract, or hormonal imbalances (2). Physical conditions that can cause spotting episodes include fibroids (abnormal growth of muscle tissue on your uterus), uterine or cervical polyps (abnormal growths on your cervix or the inside of your uterus), and endometriosis (2).
Pelvic inflammatory disease (PID), which happens when certain pelvic infections (like STIs) go untreated, can also be another culprit for unscheduled spotting (6). Other symptoms of PID can include pain in the lower abdomen, unusual vaginal discharge, and fever (6). If you suspect you have spotting and other associated symptoms of PID or physical pelvic conditions, it’s important to discuss this with your healthcare provider as soon as possible.
Urinary tract infections (UTIs) can cause bleeding from the urethra (where you pee from, between the top of your clitoris and vaginal opening). Pain while urinating, paired with a small amount of blood on the toilet paper, might be signs of a UTI (7).
Consistently spotting after penetrative vaginal intercourse is not considered normal. Bleeding after sex (postcoital bleeding) is often caused by an issue with the cervix or polyps (8). Some people may experience spotting after their first intercourse experience, which is normal. If you’re noticing spotting after sex, talk to your healthcare provider.
You can track postcoital bleeding in the Clue app by creating a custom tag.
4. Ovulation and/or hormonal issues
Spotting can also occur around the time of ovulation. Bleeding around ovulation (heavier than spotting) is considered intermenstrual bleeding (1). It’s unclear why some people experience ovulation bleeding while others don’t—some research suggests it happens in people who have higher levels of some hormones (9).
Spotting a few days before one’s period starts, in the late luteal phase, might suggest low progesterone (especially if your luteal phase is unusually short) (10), but more research is needed.
Very light and infrequent bleeding (not on hormonal birth control) can be a sign of ovulatory dysfunction. Some common causes of ovulatory dysfunction include polycystic ovary syndrome (PCOS), thyroid disorders, extreme weight loss or gain, stress, extreme exercise, and some medications like tricyclic antidepressants and phenothiazines (11). Speak to your healthcare provider if you experience this.
Not ovulating regularly — anovulation — is common during certain reproductive stages such as the first few years after menarche (the first period), postpartum, and the menopausal transition (when cycles come to an end), and may be the cause of temporarily absent or infrequent bleeding (11).
As a general rule, if you experience a sudden change in your cycle, if spotting and unexpected bleeding disrupts your daily life, or it’s accompanied by other symptoms such as pain or unusual discharge, it’s always best to speak to a healthcare provider.
Download Clue today to track spotting and your period to discover your personal patterns.
This article was originally published on October 5, 2017.