Spotting is light bleeding that can occur between periods. It usually appears as a small amount of blood when wiping or on underwear. Possible causes include birth control, pregnancy, menopause, and more.
When people experience vaginal bleeding at times other than during normal menstruation, doctors refer to this as intermenstrual bleeding. Spotting tends to occur between periods and can happen at any age after puberty.
Spotting is a very light bleed from the vagina. It differs from the light bleeding at the start and end of a period.
Several conditions, infections, and medications can trigger spotting. Although most reasons for spotting are mild, some can be severe.
This article explores the potential causes of spotting, and looks at when a person should see a doctor.
People usually notice they are spotting if they see a small amount of blood on toilet paper after wiping. They may also observe a few drops of blood on their underwear.
If a person is spotting, the amount of blood loss is not enough to cover a panty liner or pad.
Several factors can cause spotting, such as:
Birth control
Some forms of birth control list spotting as a side effect, including
- birth control pills
- birth control skin patches
- birth control implants
- intrauterine devices
Spotting is most common in the first few months of using a new method of hormonal contraception. The bleeding will usually go away without intervention.
Pregnancy
Spotting sometimes occurs during pregnancy. Around 25% of people experience some form of bleeding or spotting when they are pregnant.
During the first trimester, spotting can be due to:
- implantation, when the fertilized egg attaches to the lining of the uterus
- having sex
- hormonal changes
- cervix changes
- genetic testing, such as amniocentesis or chorionic villus sampling
Heavy spotting during pregnancy may indicate pregnancy loss. Other symptoms of pregnancy loss may include:
- abdominal cramping or pain
- fluid, discharge, or tissue passing from the vagina
- vaginal bleeding
- back pain
Heavy spotting can also be a sign of an ectopic pregnancy. Doctors call a pregnancy ectopic when the fetus grows outside of the uterus, usually in the fallopian tube. A person with this condition needs immediate medical attention.
An ectopic pregnancy may cause:
- vaginal bleeding
- abdominal pain on one side
- discomfort when passing urine or stool
- shoulder pain
Spotting or bleeding later in pregnancy can be a sign of going into labor or a complication, and a person should seek medical advice. If the bleeding is heavy, they should go to the delivery hospital immediately.
Menopause and perimenopause
When people stop having periods, doctors refer to this as menopause. This tends to develop at 45–55 years of age.
The years leading up to menopause are known as perimenopause, which can last up to 10 years.
During perimenopause and menopause, hormonal changes can impact the menstrual cycle, resulting in spotting.
Sexually transmitted infections
Some sexually transmitted infections (STIs), including chlamydia and gonorrhea, can trigger vaginal bleeding between periods. STIs can easily spread between sexual partners and lead to severe complications.
Other symptoms of STIs include:
- yellow vaginal discharge
- painful or frequent urination
- discharge from the rectum
- rectal bleeding
People who contract chlamydia or gonorrhea will need to speak to a doctor, who can usually treat these conditions with antibiotics.
Cervical cancer
Sometimes, spotting can indicate cervical cancer, which develops when cancer cells form in the cervix.
Other symptoms of this condition might include:
- bleeding after sex
- bleeding after menopause
- having longer and heavier periods than usual
- pain during sex
- pelvic pain
- swelling in the legs
- difficulty passing urine or stool
- blood in urine
Often, there is nothing to worry about with spotting, and it will go away without treatment. If it persists for a few months or more, a person should speak to a doctor.
During pregnancy, a person who thinks they may have an ectopic pregnancy or are experiencing pregnancy loss should seek immediate medical attention.
People should also seek urgent medical care if they have any bleeding later in pregnancy that does not relate to sex or labor.
Menopause-related spotting tends to stop without intervention. Anyone who finds that menopause or perimenopause symptoms interfere with everyday life should speak to their doctor.
STIs, such as chlamydia and gonorrhea, can lead to severe complications, including infertility. Anyone who believes they might have an STI should contact a doctor for treatment.
Cervical cancer can be life threatening. Those who experience cervical cancer symptoms should see their doctor as soon as possible.
Spotting is a form of vaginal bleeding. It occurs between periods and is so light that it should not cover a panty liner or sanitary pad.
Most people notice spotting as a few drops of blood on their underwear or toilet paper when wiping.
In most cases, spotting should not cause concern. Often, hormonal changes due to birth control, pregnancy, or menopause can trigger it.
Sometimes, particularly in the latter stages of pregnancy, spotting can indicate a complication. In people who are not pregnant, spotting may be a sign of an STI or cervical cancer.
Anyone worried about spotting should speak to a doctor.