Is It Spotting or My Period? Signs, Differences, and Causes (2024)

Spotting is light vagin*l bleeding that can occur outside of your regular menstrual period. It's typically different from the bleeding during your period, which tends to be heavier and more consistent.

Spotting is often harmless but can also be an indication of a problem like a sexually transmitted infection (STI) or uterine fibroids (growths in the uterus).

This article will discuss the symptoms of spotting and menstrual periods and the causes of spotting.

How Do You Know If It’s Spotting or Your Period?

Although spotting and periods both appear as bleeding from the vagin*, there are some key differences:

• Spotting is lighter and may not require the use of sanitary protection.
• Periods may also be accompanied by other symptoms that distinguish the two.

Symptoms of Normal Periods

The regular shedding of the lining of the uterus is referred to as menstruation. It may also be called a menstrual period, menstrual cycle, or menses. During this time, blood flows from the vagin*.

In people with a uterus and ovaries, it usually occurs monthly from puberty until menopause (marking the end of menstruation, when periods have stopped for 12 straight months). Menstruation normally stops during pregnancy.

Characteristics of menstrual bleeding include:

• Predictable schedule: The length of time between periods varies, but many women have a fairly predictable number of days between periods.
• Familiar pattern of bleeding: For most women, bleeding begins as light spotting, grows heavier, and then diminishes to spotting again before ending.
• Number of bleeding days: Periods typically last between 5-7 days, sometimes more, sometimes less.
  
• Red blood: Period blood is usually red but may appear brown at the beginning or end of menstruation.
• Clotting or clumping: Seeing clots or clumps of blood occasionally is normal (as the uterine lining is shed), although not all women experience this.
• Other symptoms: Right before and during a period, hormonal changes may cause additional symptoms, such as cramping, bloating, and acne.

Symptoms of Spotting

Any bleeding or spotting that occurs outside the usual time of menstruation is considered abnormal uterine or vagin*l bleeding. But this doesn't always mean it is something to worry about.

Spotting is light bleeding that comes from the vagin*. It may appear as a few spots of blood on your underwear. This will not require the use of sanitary protection like a pad, panty liner, or tampon.

Typical traits associated with spotting include:

• Unpredictable occurrences: Spotting may occur briefly or stop and start repeatedly, over one day or several, but without a predictable pattern.
• Accompanying ovulation: Spotting may happen regularly, for a day or two during ovulation. Some women experience this type of spotting every month.
• Occurrence with injury, disease, or other causes: Spotting may be caused by injury (due to intercourse or trauma), infection (e.g., yeast infections, STIs), or other causes. Blood may look pinkish-brown.
• Brown blood: Spotting often appears brown and may have a different texture or smell than menstrual blood.
• Hormonal birth control use: Starting or changing a hormonal birth control method may change the timing and amount of period bleeding.
  

What Causes Spotting?

Spotting can be normal and nothing to worry about, or it can be an indication of a problem that warrants attention by a healthcare professional.

Pregnancy and Implantation Bleeding

During the first trimester (first 12 weeks of pregnancy), 15–25 out of every 100 pregnancies will experience bleeding.

One to two weeks after a fertilized egg implants into the lining of the uterus, some spotting or light bleeding may occur. This is known as implantation bleeding. The spotting may be brownish, pink, or red and is not heavy.

During pregnancy, it is also possible to experience spotting or light bleeding following sexual intercourse, a Pap test (a swab of the cervix to check for abnormal cells), or a pelvic exam (internal and external examination of the organs in the pelvis).

Ectopic Pregnancy

An ectopic pregnancy happens when a fertilized egg grows outside the uterus, most commonly in the fallopian tube. This is a nonviable pregnancy that must be treated to prevent potentially severe (even fatal) complications.

An ectopic pregnancy may cause pregnancy symptoms like a missed period or tender breasts. It may also cause:

• Abnormal bleeding from the vagin*
• Mild cramping to one side of the pelvis
• Mild abdominal pain
• Lower back pain

Polycystic Ovary Syndrome

Polycystic ovary syndrome is a hormonal disorder that can cause irregular menstrual periods and problems with fertility. People with PCOS may experience abnormal vagin*l bleeding like spotting due to a lack of ovulation.

Hormonal Birth Control Methods

Birth control pills and other forms of hormonal contraception can cause side effects. Among these side effects is spotting, also referred to as breakthrough bleeding. This most commonly happens in the first few months of starting a new form of hormonal birth control. Spotting may stop after this time.

Uterine Fibroids or Polyps

Uterine fibroids are growths of the uterus. They are not cancerous and may not cause symptoms.

If symptoms do occur, they may include:

• Abnormal vagin*l bleeding like spotting
• Lower back pain that persists
• Pelvic pain
• Pain during sex
• Urinary issues

Uterine polyps are growths in the lining of the uterus that are usually noncancerous (although they can also be precancerous or cancerous). They may also cause spotting.

Ovulation Bleeding

Spotting can occur at any time during the menstrual cycle. Ovulation marks the middle of the cycle when the ovary releases an egg. During ovulation, some light spotting may occur. This is not a cause for concern.

Breastfeeding

People who exclusively breastfeed a child may not have a period for months or even a year after childbirth. If a person partially breastfeeds, their periods may return as soon as three weeks following birth.

When breastfeeding time is reduced and periods begin to return, this may start as light spotting.

Injuries

Injuries in the genital area can cause spotting. Injuries or trauma to the genital area include:

• Cuts
• Bruises
• Lacerations

Straddle injuries can also cause spotting. These injuries occur when a person falls onto an object, like a fence, bike, or playground equipment, and strikes the object with their groin area.

Miscarriage

The most common indication of a miscarriage (loss of a pregnancy in the first 20 weeks of gestation) is bleeding from the vagin*. Bleeding can range from a brown discharge and light spotting to heavy bleeding and clots. This can come and go.

Perimenopause

Perimenopause can occur from ages 45 to 55. During this time, the ovaries become smaller and make less estrogen. It is normal to have spotting during this time.

Cancer

Roughly 90% of people who have endometrial cancer (cancer of the uterine lining) have some form of abnormal vagin*l bleeding.

Signs of endometrial cancer include:

• Bleeding or spotting unrelated to menstruation
• Postmenopausal bleeding
• Unusual vagin*l discharge without any visible blood
• Difficult or painful urination
• Pain during intercourse
• Pain and/or mass in the pelvic area
• Unintentional weight loss
  

STIs

Not all STIs have symptoms, but STIs like chlamydia can cause bleeding between periods.

Other symptoms that may accompany spotting with STIs include:

• Unusual genital discharge
• Pain during sex
• Pain in the lower abdomen
• Bumps and sore on the genitals
• Pain with urination
  

When to See a Healthcare Provider

When experiencing spotting (along with any other symptoms), track and record when and in what pattern it is occurring and share this information with your healthcare provider.

See your healthcare provider if spotting persists, gets worse, or happens repeatedly.

Contact your healthcare provider right away if:

• You experience bleeding while pregnant.
• You experience any unexplained bleeding between periods.
• You experience any bleeding after menopause.
• You experience bleeding after sex.
• You experience heavy bleeding with periods.
• Irregular bleeding is accompanied by other symptoms such as abnormal vagin*l discharge, pelvic or abdominal pain, bruising, fatigue, dizziness, or fever.

Summary

Spotting is light bleeding that may appear as spots of blood in the underwear. Unlike menstrual bleeding, it typically does not require the use of a pad or tampon. Spotting can have many causes, including ovulation, early pregnancy, infections, or injuries to the genital area. If you are concerned about spotting, speak with your healthcare provider.