Top things to know about spotting:
Light bleeding at the beginning or end of your period is not spotting
Spotting is any bleeding outside your menstrual period
Any unexplained spotting should be addressed with your healthcare provider
Spotting can be a side effect of your hormonal contraceptive
What is the difference between your period, spotting, and bleeding?
The lines between menstrual bleeding (i.e. your period), spotting, and non-menstrual bleeding can get kind of confusing. Menstrual bleeding is bleeding that is associated with the shedding of the endometrium at the end of the menstrual cycle. Spotting has different definitions, depending on who you ask.
So what is spotting?
Researchers and healthcare providers often describe spotting as bleeding that doesn’t require sanitary protection (e.g. you don’t need to use a pad or tampon) (1).
However, this is kind of an arbitrary definition. Even if bleeding isn’t heavy, some people may just choose to use protection anyway.
In theory, spotting can happen at any time during your cycle, so around the period or between periods. Below we talk more about spotting vs. the period.
Bleeding that doesn’t seem to be associated with the period, such as bleeding during the middle of your cycle, that requires sanitary protection is called non-menstrual bleeding. Sometimes people describe this bleeding as heavy spotting.
In the rest of this article, we’re going to refer to all non-menstrual bleeding as “spotting” for convenience.
How does spotting differ from light period bleeding?
Sometimes people describe light bleeding that occurs at the beginning or end of their period as spotting.
It can be hard to differentiate spotting from menstrual bleeding by just looking at the amount. Generally, if you have light bleeding that occurs within two days of your period, you should consider that part of your period, not spotting (2). However, if it’s very, very light—like you only see a little on your toilet paper—that probably could be considered spotting.
For example, if you have light bleeding on Sunday, no bleeding on Monday, and bleed enough to require a tampon on Tuesday, you should consider Sunday the start of your period.
In Clue, there are four categories for bleeding: light, medium, heavy, and spotting.
The first 3 categories—light, medium, and heavy—are for bleeding associated with your period. Any other bleeding should be categorized as “spotting” in Clue. That way, so Clue will be able to give you more accurate predictions and insights about your body and cycles.
Why am I spotting between my periods?
Spotting can come from your upper reproductive tract (like your uterus) or your lower reproductive tract (like your cervix or vagina). Spotting is different from your period, which is the cyclical shedding of your uterine lining, your endometrium. Heavier spotting is most often from the uterus, while lighter spotting can come from the upper or lower tract (3).
Common causes of spotting
1. Hormonal contraception and spotting
Spotting is a common side effect of hormonal contraception, especially during the first few months of starting a new method (4).
If you’re taking combined oral contraceptives (the most common type of birth control pill), you may have spotting that goes away after a couple of months (4). If spotting between withdrawal bleeding continues, your pill may not be the best fit for you, and you may want to try another brand with a different chemical formulation (4). Spotting might also happen if you forget to take your pills and the levels of the pill’s hormones drop in your body.
Spotting is common and often unpredictable with the hormonal IUD, the contraceptive implant, the contraceptive shot (injection, and the mini-pill (a progestin-only pill) (5).
2. Pregnancy and spotting
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) (6). 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 (6). However, heavy spotting or bleeding may be more of a concern. If you’re pregnant and bleeding, call your healthcare provider to let them 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 (6).
Spotting can be a symptom of an ectopic pregnancy (7). This is a pregnancy that is growing somewhere other than the uterus, usually the fallopian tube. Ectopic pregnancy bleeding may be coupled with other symptoms including abdominal pain on one side, shoulder pain, and/or dizziness. If you experience symptoms of spotting and suspect you may have an ectopic pregnancy, seek immediate medical help.
3. Physical conditions, infections, and spotting
Spotting can also be caused by infections and physical changes in the reproductive tract, or hormonal imbalances. 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 (8).
Pelvic inflammatory disease (PID), which happens when certain pelvic infections (like STIs) go untreated, can also be another culprit for unscheduled spotting. Other symptoms of PID can include pain in the lower abdomen, unusual vaginal discharge, and fever (9). If you suspect you have spotting and other associated symptoms of PID or of 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 your clitoris and vagina). Pain while urinating, paired with a small amount of blood on the toilet paper, might be signs of a UTI (10).
Consistently spotting after penetrative vaginal intercourse is not considered normal. Bleeding after sex (postcoital spotting) is often caused by an issue with the cervix or polyps (11). 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.
4. Ovulation, hormonal issues, and spotting
Spotting can also occur around the time of ovulation. 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 (12).
Spotting a few days before the period starts, in the late luteal phase, might suggest low progesterone (especially if your luteal phase is unusually short) (13), but more research is needed.
Understanding your body can improve usage of non-hormonal birth control. Click here to learn more about Clue Birth Control.
This article was originally published on October 5, 2017.