Spotting is light bleeding usually associated with the menstrual cycle, but it is not considered to be a period. A range of other factors can cause it, including birth control pills, pregnancy, and stress.

A person might use a pad or not need any menstrual products for spotting that is light or infrequent. Anyone who has spotting instead of a period may want to take a pregnancy test.

If spotting or any other menstrual irregularities are persistent, contact a doctor. This is especially important if there are other symptoms, such as pain, if there have been more than three missed periods in a row, or if any bleeding happens after the onset of menopause.

This article describes what spotting is, what causes it, and when to see a doctor.

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Spotting is a small amount of blood shed during the menstrual cycle, but not enough to be considered a period.

The average period typically involves 2–3 tablespoons of menstrual blood shed over 4–5 days. Spotting involves significantly less blood.

Sometimes it signals the start of a period, but spotting may occur throughout the cycle. Spotting can also be an early indicator of pregnancy, a sign of stress, or a symptom of several health issues.

Doctors consider having spotting instead of a period a “menstrual irregularity,” but these are not exactly rare. In fact, 14–25% of females of reproductive age have irregular periods.

Some causes of spotting include:

Birth control pills

It is not unusual for people to have spotting when taking birth control pills, especially in the first few months of use. A person may, for example, have spotting if they are taking progestin-only pills or pills that provide the same amounts of hormones every day.

Learn more about the side effects of birth control pills here.

Pregnancy

Spotting during the first trimester is not rare and does not necessarily point to a problem. It happens for 15–25% of pregnant people.

Also, some people have implantation bleeding when the fertilized egg embeds in the lining of the uterus, and this can look like spotting.

Anyone who has spotting instead of a period may want to take a pregnancy test.

Learn more about pregnancy here.

Stress

Mental and physical stress can alter the release of hormones and affect the menstrual regulatory pathways. This might lead to spotting.

If stress becomes hard to manage, consider contacting a doctor. A treatment plan might involve medication, stress management techniques, or a combination.

Learn more about stress here.

Menopause

Several years before menopause, spotting and other menstrual irregularities may occur. After the first symptoms, it may take about 4 years for the body to transition to menopause.

After a person has entered menopause, they should contact a doctor about any bleeding or spotting.

Learn more about menopause here.

Thyroid problems

The thyroid is a butterfly-shaped gland in the neck, and its hormones play an important role in regulating several bodily processes, including menstruation.

When thyroid hormone levels are too high or low, periods may be irregular, and there may be spotting.

To diagnose the issue, a doctor requests a blood test to check the levels of these hormones. Treatment aims to balance the levels and ease the symptoms.

Learn more about thyroid disorders here.

Polycystic ovary syndrome

Some symptoms of polycystic ovary syndrome (PCOS) include missed periods and spotting, as well as weight gain, acne, and unwanted hair growth.

Researchers have not yet determined what causes PCOS. While there is no cure, there are ways to manage most symptoms and help with conceiving, if necessary.

Learn more about PCOS here.

Cancer

According to the American Cancer Society, 90% of women with endometrial cancer bleed between periods and experience bleeding after entering menopause. Pelvic pain and weight loss are also symptoms.

Learn more endometrial cancer here.

Spotting and unusual vaginal bleeding can also be symptoms of cervical cancer. In addition, some people experience pain during sex, pelvic pain, and unusual discharge, which can be bloody.

Learn more about cervical cancer here.

During menstruation, the body releases blood and tissue from the uterine lining. It leaves the uterus via the cervix and exits the body through the vaginal opening.

With spotting, however, the source of the blood can vary, depending on the cause. For example, if the spotting is a symptom of cervical cancer, the blood comes from the cervix, not the uterine wall.

A wide range of factors can cause spotting, and the issue could be benign or require medical attention.

A person should speak with a doctor if they experience:

  • frequent spotting
  • more than three missed periods in a row
  • spotting with pelvic pain, unusual discharge, or any other symptoms
  • any bleeding or spotting after the onset of menopause

Menstrual cycles vary from person to person, and spotting is not uncommon. A range of factors, including stress, early pregnancy, and certain health issues can cause it.

If spotting persists and accompanies any other symptoms, such as pelvic pain, speak with a doctor. It is also important to do this if any spotting occurs after the onset of menopause.