Spotting Before Your Period? Here Are 15 Potential Causes
Signs of spotting are often seen on stained undergarments or toilet paper after using the restroom. Spotting, or light bleeding, may occur for many reasons and is defined as abnormal vaginal bleeding when it happens outside of your regular period.
Spotting before your period is rarely anything to worry about but can occasionally hint at a serious health issue. Many of the causes of spotting are treatable and even curable. Read on to learn more about your menstrual cycle and some reasons why you could be spotting.
What is spotting?
Spotting is defined as any vaginal bleeding that occurs outside of your monthly period. Usually, spotting is light but certain health issues — such as endometriosis or uterine fibroids — can cause heavier bleeding outside your menstrual period.
Spotting often takes women by surprise. Unlike a menstrual period, it does not typically follow a predictable pattern. This can make spotting an annoyance for many women. After all, no one wants to stain their favorite underwear unexpectedly!
Luckily, spotting usually occurs only occasionally, rather than during every menstrual cycle. The causes of spotting are often treatable or even reversible. If you are struggling with inconvenient spotting between periods, here’s what you should know to help you identify the cause.
Understanding Spotting Timelines
Spotting can occur at any point in your menstrual cycle, outside of your regular menstrual period. You should pay attention to whether spotting arrives in the middle of your cycle or just a few days before your period, as spotting can have different meanings depending on when in it occurs.
Spotting More Than a Week Before Your Period
If spotting occurs more than a week before your period is due to arrive, it is unlikely to mean that your period has arrived early (unless, of course, you have very irregular cycles). Unless it happens regularly during each cycle, spotting in the middle of your cycle may indicate an abnormal cause. This type of spotting can be caused by ovulation, which is more likely if it occurs at the same point during each cycle; hormonal birth control; or, less likely, another more serious health condition.
Spotting a Few Days Before Your Period
Spotting a few days before your period may be due to pregnancy or another medical condition — but it can also indicate that your period has arrived earlier than usual. Many women notice that when their period arrives early, it is lighter than usual. As a result, an early period may more closely resemble spotting than regular menstrual bleeding.
If you are trying to conceive, however, pay special attention to spotting a few days before your period, especially if it is brown or light pink in color: this might signify implantation bleeding, a sure sign that you should take a pregnancy test when your period is due to arrive.
Reasons for Spotting Before Your Period
Whether it happens weeks or just a few days before your period is set to arrive, spotting can occur for a myriad of reasons. Ultimately, because there are so many potential causes, you should always visit your doctor to discuss any abnormal vaginal bleeding. He or she can help you identify the cause with exact certainty.
If you’re looking to become more informed before your appointment, or just better understand your body, the following reasons are a good place to start.
1. Hormonal Birth Control
Whether it’s a pill, patch, or injection, hormonal birth control can cause spotting within the first three months of use. Medical professionals call this ‘breakthrough bleeding.’ This can be linked to changes in the uterine lining, or endometrium, caused by hormone disruptions stemming from your birth control. Barrier methods like latex condoms aren’t associated with spotting — but the copper IUD may still cause bleeding, even though it does not contain hormones.
Skipping pills, or completely stopping the use of birth control pills, can cause spotting to occur as well. This is normal, and not a red-flag. However, you should use hormonal birth control with caution, as taking or replacing birth control irregularly can lead to an unplanned pregnancy.
2. Sexually Transmitted Infections (STIs)
Sexually transmitted infections (STIs) are on the rise in many areas around the globe and may lead to abnormal vaginal bleeding in women. For instance, chlamydia and gonorrhea can cause spotting before your periods and after having sexual intercourse. These STIs can cause pelvic inflammatory disease if left untreated.
Symptoms of pelvic inflammatory disease include:
- Lower abdominal pain
- Abnormal bleeding during or after intercourse
- Fever sometimes with chills
- Heavy, foul-smelling vaginal discharge
Pelvic inflammatory disease is a serious condition that can lead to infertility if left untreated, so seek medical attention immediately if you suspect that you may have it.
3. Uterine Fibroids
Uterine fibroids are non-cancerous tumors that develop in the lining of the uterus, or endometrium. The reason why fibroids can cause spotting is not entirely known. One theory is that uterine fibroids lead to the overproduction of certain hormones, potentially causing spotting weeks before your period. Another theory is that the uterine fibroids cause the lining of the womb to stretch. Thus, the veins surrounding the womb become more fragile and more susceptible to breakage, causing abnormal vaginal bleeding.
In a 28-day cycle, ovulation happens about 14 days before your menstrual period begins. During ovulation, a handful of women secrete cervical fluid with blood streaks or a slight hint of blood. Hormonal changes during ovulation may be responsible for this kind of discharge.
When progressing to ovulation, the body’s estrogen levels increase. As a result, you may notice some spotting. It’s important to know that tracking vaginal spotting alone doesn’t give you complete information about your hormone levels.
The Mira Fertility tracker tracks your actual hormone concentrations and shows your unique hormone curve. Mira provides easy to understand fertility insights based on your unique hormone data, to take the guesswork out of ovulation tracking. It can also help you identify if high estrogen prior to ovulation is causing your spotting.
5. Implantation Bleeding
Implantation bleeding happens when a fertilized egg implants in the inner uterine lining, leading to pregnancy. Not every pregnant woman will experience implantation bleeding, but if you do experience light spotting during implantation, it is perfectly normal and not at all dangerous.
When implantation bleeding occurs, it usually happens several days prior to your next menstrual period. The discharge appears to range from a lighter pink to a muddy brown color. The flow of blood is significantly lighter than a regular period and is much shorter.
Other symptoms of pregnancy that may occur alongside implantation bleeding include:
- Mild headaches
- Feeling nauseous
- Rapid mood changes
- Tender breasts
- Lower backache
Implantation bleeding doesn’t endanger your unborn child. However, if you are pregnant and experience a heavy period instead of spotting, seek medical advice from a professional.
6. Cervical Cancer
Rarely, cervical cancer can be responsible for spotting and other forms of vaginal discharge. Cervical cancer is more likely to occur in women that have reached menopause but can still happen to younger women. Most of the time, spotting is not due to cancer, though you should consider getting checked out by an OB/GYN, especially if you are over the age of 40.
Cervical cancer can cause vaginal bleeding between periods, even after menopause. In addition, cervical cancer can cause brown spotting and irregular discharge that smells unpleasant, and looks watery or blood-tainted.
7. Polycystic Ovarian Syndrome (PCOS)
Polycystic ovarian syndrome (PCOS) results from excess levels of male sex hormones, called androgens. High androgens can also cause irregular periods. In some cases, if you have PCOS, you may not ovulate regularly or at all. With a lack of regular ovulation, spotting may occur between periods.
Symptoms of PCOS also include:
- Decreased fertility
- Oily skin
- Rapid hair growth
- Rapid weight gain
Think you may have PCOS? Make an appointment with your OB/GYN. He or she can diagnose you via hormone testing, and possibly an ultrasound to examine the ovaries. The symptoms of PCOS are highly treatable and can be solved with medication and changes in lifestyle.
When approaching menopause, your hormone levels shift. As a result, the lining of your uterus thickens. This can lead to irregular bleeding or heavier menstrual periods than usual.
Perimenopause makes it difficult to predict when your period will start. You may experience some spotting, along with symptoms like:
- Longer or shorter cycles than usual
- Anovulatory cycles
- Hot flashes
- Sleep problems
- Vaginal dryness
While menopause is unavoidable, treatments are available to help ease the symptoms and make you feel more comfortable while going through it.
Most people assume that bleeding during pregnancy is a bad sign. However, it is surprisingly common to experience light vaginal spotting — particularly during the first trimester. As many as 20% of women experience some spotting during the first 12 weeks of their pregnancy.
Besides implantation bleeding, spotting during pregnancy often follows sexual intercourse, gynecological exams, and/or exercise. It may also be caused by a cervical polyp which is more likely to bleed during pregnancy due to increased estrogen levels.
There is an important difference between bleeding and spotting during pregnancy. You should not see enough blood to need a pad or tampon nor to soak through a pantyliner. However, heavy bleeding could be a sign of an ectopic pregnancy or miscarriage and you should also talk to your doctor if you experience spotting during the second or third trimesters
10. Vaginal Trauma
An injury to the vagina, known as vaginal trauma, can cause spotting. Common causes of vaginal trauma are sexual activity and/or assault. If you experience bleeding after a sexual assault, you should visit a medical provider to ensure there is no serious injury. You should also see a doctor if the bleeding is heavy, if there is blood in the urine, or if there is an object stuck in the vagina.
Many women experience light bleeding after painful sex, especially if it is their first time. This bleeding is usually not heavy and does not last very long. Vaginal trauma from sexual intercourse can be caused by a lack of lubrication and engaging in plenty of foreplay while using a lubricant can make sex more comfortable and prevent spotting from vaginal trauma.
Vaginal trauma can also be caused by infections like candidiasis (yeast) in the vagina. These infections cause inflammation in the vagina, which can make the area more sensitive and prone to bleeding — especially following sexual intercourse. Again, this bleeding is usually not heavy and will go away with treatment of the underlying infection.
11. Pelvic Inflammatory Disease (PID)
We talked a little about pelvic inflammatory disease (PID) when we talked about STIs. PID occurs when a vaginal infection, such as a yeast infection or STI, is left untreated and spreads to the upper reproductive organs. The best way to prevent PID is to promptly treat any and all vaginal infections with the correct medications.
Like STIs, PID may lead to abnormal vaginal bleeding. Other symptoms of PID include:
- Abdominal pain
- Unusual, foul-smelling vaginal discharge
- Sexual pain and/or bleeding
- Burning sensation while urinating
It’s important to seek treatment right away if you suspect you may have PID. The complications of PID can be severe and may include scarring and infertility.
Endometriosis is a reproductive health condition where tissue similar to the lining of the uterus, called the endometrium, grows on other organs and anatomical structures. Like the endometrium, this tissue bleeds each month, causing pain and inflammation throughout the body.
Endometriosis can lead to heavy, painful periods and abnormal vaginal bleeding. Other symptoms of endometriosis may include:
- Chronic pelvic pain
- Pain during sex
- Nausea or vomiting, especially during your period
- Constipation and/or diarrhea, especially during your period
- Painful bowel movements, especially during your period
- Rectal bleeding, especially during your period
Psychological stress can cause abnormal vaginal bleeding by creating a hormone imbalance in the body. When the body’s “fight-or-flight” response is triggered, the body starts to produce the stress hormone cortisol. High cortisol then prompts the body to produce more estrogen, leading to abnormally high levels.
These high estrogen levels can cause spotting and other irregularities with your menstrual period. Thankfully, proactively managing your stress should reverse the hormone imbalance, and your period should return to normal soon after.
In addition to hormonal birth control, several other medications can cause spotting. Theoretically, any medication that changes hormone levels in the body could lead to spotting or other changes with your menstrual period. However, some of the most common culprits behind spotting due to medication are:
- Aspirin and other blood-thinners
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Thyroid medication
Talk to your doctor if you experience unexpected spotting while taking one of these medications. He or she can assure you whether this is an expected side effect and if you need to change your regimen.
15. Underactive Thyroid
Your thyroid is a butterfly-shaped gland in your throat that produces thyroid hormones. When that gland produces too few hormones, it is known as an underactive thyroid or hypothyroidism.
Hypothyroidism can affect your menstrual cycle by impairing estrogen detoxification and reducing the amounts of a hormone called globulin, which binds to sex hormones. As a result, you may experience high estrogen, leading to heavy menstrual bleeding and/or spotting.
Other symptoms of hypothyroidism include:
- Weight gain
- Memory changes
- Muscle and joint pain
It’s very important to treat hypothyroidism, as the thyroid plays an important part in the functioning of many parts of the body. Talk to your doctor if you experience symptoms of hypothyroidism so he or she can test your levels of thyroid stimulating hormone (TSH). If your TSH levels are too low, you may be prescribed medication to replace them.
Is it spotting or your period?
If you’ve read this far, you’ve probably learned a lot about spotting. Still, you might be wondering how to tell the difference between spotting and your period, especially if spotting occurs close to the expected start date of your next menstrual period. So, how can you tell if you are spotting or if your period has simply arrived early?
Unlike menstruation, spotting has the following characteristics that set it apart:
- Irregular timing. While your period typically comes around the same time each month, you can spot at any point in your menstrual cycle. Spotting does not follow a pattern the way menstruation does. One cycle, you may experience some spotting a few days before your period, while the next, you may experience it around ovulation.
- Associated with other symptoms or medications. If you spot during ovulation or due to a medical condition, spotting likely won’t be your only symptom. You will probably also experience other symptoms throughout the body. While menstrual periods can cause some symptoms, like cramping or fatigue, they usually do not cause significant problems throughout the body — whereas other conditions, like PCOS, endometriosis, or hypothyroidism, might.
- Lighter. Spotting is usually much lighter than your typical menstrual period. Many women have light bleeding at the beginning and end of their periods, but find that it becomes heavier in the middle. Spotting, however, is usually very light and should not cause you to need a pad or tampon. Sometimes, it may also be a different texture or have an unusual odor, compared to your usual menstrual flow.
- Different color. Your menstrual period is usually the same color each month. It may start out a light pink or red, become bright red, and end as brown or black. But spotting can be any color along this spectrum, and does not typically follow a pattern. It is also less likely to be bright red, and more likely to be pink or brown, than menstrual bleeding.
- Shorter. Spotting can last anywhere from a few hours to a day or two, but it is usually much shorter in duration than your typical menstrual period. A normal menstrual period lasts three to seven days. Spotting usually does not last that long, though it can last for many days in some cases.
✔️ Medically Reviewed by Banafsheh Kashani, MD, FACOG
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.
Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).