For example, spotting after your period can be a sign of miscarriage, a hormonal condition, or cancerous or noncancerous growths. Bleeding that is accompanied by vaginal discharge can indicate an infection.
This article will go over the most common reasons for bleeding between periods. You’ll also learn when to call your healthcare provider.
Spotting After a Period
A tinge on your toilet paper or a drop or two of blood in your underwear is likely to be spotting. Your healthcare provider will only consider bleeding to be “spotting” if it occurs before or after your period and does not require you to use a pad or tampon.
You’re probably used to seeing bright red or slightly dark red blood when you’re on your period. If you’re spotting, the blood might be lighter (pinker) or darker (brown). Older blood is usually brown or even close to black.
If you have an infection, you may have vaginal discharge along with spotting. Depending on what is causing the infection, the discharge can be white, yellow, or green.
Light to Heavy Bleeding Between Periods
More substantial bleeding in between periods may or may not be worrisome:
Light bleeding: This type of bleeding occurs just before or after your period. It’s not technically spotting—it’s considered part of your period. Breakthrough bleeding: Breakthrough bleeding happens if you are taking oral contraceptives. This type of bleeding between periods is usually caused by low estrogen levels. Abnormal bleeding: Any heavy bleeding that requires the use of a tampon or pad that happens outside of your cycle and is not caused by hormonal birth control pills is abnormal. It is also called abnormal uterine bleeding or abnormal vaginal bleeding.
What Is Normal Menstrual Bleeding?
Normal menstrual bleeding lasts for about five to seven days. The average menstrual cycle has about 28 days between periods, but it’s still normal to have a cycle that’s anywhere from 21 to 35 days.
About 14 days after the start of your period, your ovaries release an egg. This is called ovulation. Some people notice spotting during ovulation, which can be normal. However, you should tell your provider if you notice it.
If the egg is not fertilized, a period starts approximately two weeks after ovulation. During a period, the uterine lining is shed because it’s not needed to support a pregnancy.
Causes of Spotting and Light Bleeding
There are several possible causes of light bleeding between periods.
Pregnancy
Spotting can occur during pregnancy. There are a few different causes, some of which are serious:
Implantation bleeding: Spotting can happen when the fertilized egg implants in the uterus and begins to grow. Miscarriage: Bleeding that happens early in pregnancy—especially if it’s heavy—may mean that you’ve had a miscarriage. Ectopic pregnancy: This occurs when a fertilized egg implants outside of the uterus. One of the signs is vaginal bleeding. An ectopic pregnancy is a medical emergency. Abortion: Bleeding can occur after terminating a pregnancy using medication or having an abortion procedure.
Birth Control
Bleeding between periods can also happen because of your birth control method.
Oral contraceptives: Starting, stopping, or missing oral contraceptives (birth control pills) can cause spotting or breakthrough bleeding. Other hormonal birth control methods: Irregular vaginal bleeding can happen if you’re using the contraceptive patch, implant, or injection. Intrauterine devices (IUDs): Intrauterine devices may cause occasional spotting.
Hormonal Conditions
If you have certain medical conditions related to your hormones, you might be more likely to experience spotting between periods.
Thyroid disease (either low or high thyroid hormone levels) Polycystic ovary syndrome (PCOS) (a hormone imbalance that affects ovulation) Perimenopause (which can cause irregular periods, vaginal dryness, or vaginal atrophy)
Common Infections
Infections are another common cause of bleeding between periods.
Vaginal, cervical, and uterine infections and inflammatory conditionsSexually transmitted infections (e. g. chlamydia, gonorrhea, and genital warts) Pelvic inflammatory disease (PID)
Other Causes
There are also some other causes of spotting between periods:
Endometriosis (abnormal growth of uterine-like tissue outside the uterus) Injury (e. g. , insertion of foreign objects into the vagina or sexual trauma) Uterine fibroids (noncancerous growths in the uterus) Cancer (e. g. cervical cancer, uterine cancer, uterine sarcoma, ovarian cancer, and vaginal cancer) Medications (e. g. , anticoagulants and tamoxifen) Gynecological procedures (e. g. , a Pap smear) Urethral prolapse or uterine polyps
When to See a Healthcare Provider
It can be useful to keep track of your menstrual cycle using a calendar or app. This information can help your healthcare provider figure out whether or not any spotting or bleeding outside your cycle is a concern.
If you think you might be bleeding too heavily, also make a note of how many pads or tampons you go through in a day.
Any unexplained vaginal bleeding between periods is a reason to call your provider. It is especially important to call if you haven’t yet gone through puberty or if you are past menopause.
Diagnosis
When you see your provider about bleeding or spotting between periods, they will ask about your medical history. If you’ve been tracking your menstrual cycle, that information will help them.
Some questions your provider may ask:
How long have you experienced bleeding between periods? Does it happen every month or is this the first time? At what point during your menstrual cycle did the bleeding begin and how long did it last? Do you experience menstrual cramps with the bleeding? Does anything make the bleeding worse or better? Is the bleeding worse with increased physical activity?
If you are pregnant or recently had a miscarriage or abortion, let your provider know. You should also tell them if you’ve been injured or undergone any gynecological or surgical procedure recently.
If you’re seeing a provider for the first time, they’ll want to know how old you were when you first started having periods. They will also ask if you are sexually active, and which birth control method you use.
Remember to tell your provider about any prescription or over-the-counter (OTC) medications (including herbal supplements) that you are taking.
Your provider might give you a pelvic exam including a Pap smear if you haven’t had one or it’s been a while since your last one. They might want you to have additional tests, such as blood tests or imaging tests, to help them make a diagnosis.
Treatment
The treatment for bleeding between periods depends on what’s causing it. Medications like birth control or antibiotics for infections might be prescribed. In some cases, your provider might want you to have a procedure or surgery.
Summary
Many people experience spotting or bleeding between periods. Most of the time, a little bleeding when you’re not on your period is not a reason to worry.
However, if you’re also having other symptoms like pain, spotting between periods can be a sign that something is wrong.
If you experience any vaginal bleeding, light or heavy, tell your healthcare provider. That’s the only way to find out for sure what is causing it—and make sure you get the right treatment.
