Spotting before period or spotting in between the menstrual cycle is quite common. Spotting is the light vaginal bleeding that occurs outside your expected menstrual cycle. Spotting is different from periods in the amount of blood flow. A menstrual cycle takes place on average every 28-35 days. A menstrual period lasts for 3-7 days, involves heavy bleeding, and requires a pad, tampon, or menstrual cup to regulate the blood flow. Whereas spotting involves a small amount of blood, as its name suggests, which may look like small spots of pink, red, or brown.
1. 10 Interesting Facts About Spotting Before Period
- Spotting is lighter than your regular menstrual1 bleeding.
- It looks like small drops or ‘spots’ of blood which you may notice on your underwear or when you use a paper toilet.
- Spotting can range from light pink in color to dark brown in color.
- It usually lasts a few hours to a few days.
- Spotting does not require using sanitary products like pads or tampons.
- Spotting outside your menstrual period is not associated with pain and is not harmful in most cases.
- Spotting may occur due to a variety of causes like hormonal imbalances, some underlying health conditions, taking birth control medications2, injuries or STIs3, etc.
- Spotting may also mark the onset of menopause4.
- Stress, depression, and anxiety can also lead to spotting.
- Spotting can happen at any age after one hits puberty5.
1.1 How Can You Differentiate Between Spotting And Menstrual Bleeding?
- Spotting is bleeding found in tiny drops on your underpants. Whereas, menstrual bleeding involves heavy bleeding or blood flow that lasts up to 3-7 days. The average period blood typically involves 2-3 tablespoons of menstrual bloodshed.
- It doesn’t require using any products and just wearing your underwear is enough. Whereas during menstrual bleeding, one needs to use sanitary products like pads, tampons6, etc.
- Usually, spotting or in between your menstrual cycle is not harmful or life-threatening. It may even be normal depending on your age or other factors such as pregnancy.
- However, it is always safe to be sure of the underlying cause of spotting before your period, and if you are not do seek medical attention.
2. Types of Bleeding :
Now, that we know about spotting and what makes it different from period bleeding, let’s discuss some types of bleeding that may lead to spotting before period.
2.1) Light Bleeding –
Periods significantly vary from person to person and even from month to month. Sometimes light bleeding can indicate the start of your regular menstrual period before becoming heavier. However, this may not always be the case; it can also be a signal that there is something else going on.
First, we should understand how much blood flow is normal during a regular menstrual period. According to a study by Dr. Jane Van Dis at the University of Rochester, typical bleeding varies depending on age, hormonal status, and medication. ” On average, it’s somewhere between 5 to 80 ml, but the majority of women lose between 30 to 40 ml.” – she said. That is about 3 to 4 tablespoons, as mentioned earlier.
Now, according to the International Federation of Gynecology and Obstetrics, light bleeding or spotting is anything that is less than 5 ml, which is much less than a tablespoon. It also generally lasts for a shorter duration of 1 to 2 days.
2.2) Vaginal Bleeding –
Vaginal bleeding occurs either due to the menstrual cycle or caused by other problems in the reproductive system or abnormal uterine bleeding. Abnormal bleeding could be a sign of something minor or severe that may be harmful to life, for example, spotting may also sometimes be a symptom of cancer, a bleeding disorder, an infection, or an injury.
Some common causes of vaginal bleeding include :
- Ovulation spotting – Ovulation spotting looks like a few drops of blood on your underwear or on toilet paper and occurs around the time when you ovulate. Ovulation starts when your ovary starts to release an egg. Not all women experience ovulation spotting. A study found that only 5% of regularly menstruating women experience spotting between periods. This kind of spotting between periods does not usually signal a serious problem.
- Perimenopause7 – Perimenopause is when your body gets ready to make the natural transition to menopause, marking the end of your reproductive years. The color of the blood during this transition is usually brown or dark. Most often, it starts in women from ages 40-44. During menopause, you may experience hot flashes, mood swings, or vaginal dryness. You may also notice some other symptoms, such as changes in your vaginal discharge, which may be thin and watery or clumpy and thick.
- Menopause8 – Research shows that up to 11% of post-menopausal women experience some menopausal bleeding or spotting. Post-menopausal bleeding can range from light brown spotting to light pinkish-gray spotting to heavy blood flow, like in regular periods. Most of the time it is a pain without bleeding. But make sure to contact your healthcare provider and have yourself examined.
- Stress – Stress can lead to light spotting before periods. It is also a common cause of irregular bleeding and menstrual bleeding patterns’ late or early appearance.
- Hormonal imbalance – Vaginal spotting may happen due to changes in hormone levels. Hormonal changes or hormone imbalances in the body occur due to too few hormones or excess hormones. This also leads to bleeding, missed menstrual cycles, or abnormal bleeding. Here the hormones called estrogen and progesterone play a very important role. An imbalance in the estrogen level may affect women during perimenopause and menopause. Progesterone helps prepare the uterus lining for implantation after ovulation during the second half of the menstrual cycle. It allows for the complete shedding of the uterus lining during the menstrual period.
Some common causes of hormonal changes are:
- Having irregular periods
- Having eating disorders
- Taking too much stress
- Polycystic ovary syndrome10 (PCOS)
- Taking hormonal contraception pills.
Some simple ways to help prevent hormonal imbalances are :
- Maintaining a healthy weight
- Regular hormone testing
- Eating a balanced diet
- Exercising regularly
- Managing your stress
- Getting good quality sleep
- Quit smoking and using tobacco products
- Hormonal birth control pills – Breakthrough bleeding, i.e., light spotting before period is a common concern among women using any hormonal birth control pill, especially during the first few months. People who smoke or forget to take their birth control pills are more likely to experience spotting or bleeding during the menstrual cycle. This vaginal bleeding can last for a few days, but if it exceeds for more than 7 days, then do seek professional medical advice.
- Other hormonal birth control methods – If you use other birth control methods like a contraceptive patch, implant, or an injection, it may lead to irregular or abnormal vaginal bleeding.
- Intrauterine devices11 (IUDs) – Intrauterine devices may cause occasional spotting. A new device (IUD) looks like a small, flexible, plastic device that is shaped like the letter T. It is a contraceptive device fitted inside the uterus, and it physically prevents the implantation of fertilized ova or egg, thereby preventing pregnancy. IUDs are perfectly safe and are 99% effective in preventing pregnancy. They also prevent the transformation of sexually transmitted diseases.
- Sexual intercourse – Light bleeding or spotting after sexual intercourse is common, but it may be harmful. During sex, the vagina needs to be well lubricated to prevent vaginal dryness for a woman to experience sex without pain. Vaginal dryness may result in irritation due to the use of less lubrication during sexual intercourse and cause excessive friction, which may damage the cervix or vaginal tissue leading to light abnormal uterine bleeding during or after sex. Sexual assault, having painful sex, and having vigorous or rough sex may also lead to vaginal bleeding.
- Sexually transmitted infections – Sexually transmitted infection (STI) is an infection that passes from one person to another through intimate contact or while having unprotected sexual intercourse. STIs can spread through oral, vaginal, or anal sex or even sexual assault. It can also be passed on by skin-to-skin genital contact.
Some common STIs :
- Human papillomavirus (HPV)
- Hepatitis B
- HIV/ AIDS & STDs
- Pelvic inflammatory disease (PID)
- Bacterial Vaginosis (BV)
Sometimes sexual intercourse can lead to post-coital bleeding or bleeding after having sex which can be a sign of health conditions like an infection, such as pelvic inflammatory disease (PID) or chlamydia.
People with STIs may experience other symptoms like :
- Heavy vaginal discharge or spotting before period
- It can also cause unusual smelling and discolored or unusual vaginal discharge, pelvic pain, rashes or itches around private areas of the body, painful or burning urination, and pain or swelling of glands around the genital region.
- It may also cause pain while having intercourse.
If you experience the symptoms mentioned above after having a sexual act, then immediately get yourself tested and take the opinion of your healthcare provider. STIs may result in complications in pregnancy, pelvic inflammatory disease (PID), damage to reproductive organs, and transmission of infections to the fetus. Some STIs like HIV and HBV (hepatitis B) can cause a reduced life span. This is why it is very important to practice safe sex by using condoms and using birth control contraceptives. Chances of getting a sexually transmitted disease increase if you have multiple sex partners.
2.3) Implantation Bleeding –
Ovulation occurs every month when an egg is released from an ovary. This egg travels down the fallopian tube. Here fertilization occurs when a sperm unites with an egg to form a zygote, also known as a fertilized egg. If fertilization does not occur, the egg and uterine lining are shed in the form of a menstrual period.
On the other hand, if the sperm penetrates the egg, the zygote then continues to travel down the fallopian tubes to attach or implant itself to the inner uterine lining. If the implantation is successful, a hormone called human chorionic gonadotropin is produced to help prevent the uterine lining from shedding. Light bleeding or spotting occurs when a fertilized egg attaches itself to the uterine wall. This is called implantation bleeding, and it typically occurs in very early pregnancy, after 6-12 days of conception, and is experienced by 30% of pregnant women.
Implantation bleeding may last for a few hours or a day. It may be constant or start and stop, but it is not life-threatening and usually doesn’t require medical attention. However, it is always wise to let your doctor know about this and ensure no serious underlying cause exists. Some common
symptoms of implantation bleeding are headache, breast tenderness, very light bleeding, nausea, light cramping, mood change, lower backache, etc.
2.3.1) How can you differentiate between implantation bleeding and menstrual period blood ?
- Implantation bleeding is usually very light pink to brown in color. Whereas period blood is very dark and bright red in color.
- Implantation bleeding does not require any sanitary protection like in the case of menstrual bleeding.
- Implantation bleeding is very light and may only be noticeable when the area is wiped or may appear as tiny spots in your underwear. Whereas during the menstrual period, blood flow is very heavy.
Some other causes of bleeding during pregnancy include :
- Ectopic pregnancy – When a fertilized egg implants and grows outside the main cavity of the uterus, an ectopic pregnancy occurs. It mostly happens in the fallopian tube while the egg travels through it. Hence, it is also known as tubal pregnancy. The warning signs of an ectopic pregnancy are sharp abdominal cramps, light vaginal bleeding, and pelvic pain. You may also feel like vomiting due to an upset stomach and the urge to have a bowel movement.
- Miscarriage – The first trimester of pregnancy is a crucial time, and most miscarriages happen before the 12th week of pregnancy which causes vaginal bleeding, the most common sign. Other symptoms include cramping and lower abdominal pain. It is also common to pass large blood clots.
- Abortion – Terminating a pregnancy can cause abnormal vaginal bleeding. This usually lasts for only 1 to 2 weeks but sometimes may last up to several weeks. You may also see some other symptoms like abdominal pain and passing some blood clots or tissue. It is normal to experience spotting after your abortion for several weeks.
2.4) Abnormal Uterine Bleeding (AUB) –
Abnormal uterine bleeding is bleeding from the uterus that lasts for a prolonged period of time and involves extremely heavy bleeding or bleeding at irregular times. AUB can occur as spotting before your period or bleeding between your periods. If this bleeding lasts for more than a week, this may indicate that something is out of balance, and you should immediately seek the help of your healthcare provider.
Some common causes of AUB include :
- Uterine fibroids – Uterine fibroids may be red, pinkish, or brown in color and are rounded growths that look like nodules of smooth muscle tissue and are noncancerous growths of the uterus that often appear during childbearing years. These are common, and between 20 to 70 percent of women develop fibroids during their reproductive years. And these are not at all harmful or risky. But this doesn’t mean you should turn a blind eye, as fibroids can cause complications like excessive bleeding and reproductive problems. Fibroids’ causes are still unknown, but treatments are available to help one get rid of them. Myomectomy is an operation used to remove fibroids.
Some symptoms of uterine fibroids you may experience are :
- Heavy bleeding
- Spotting before period
- Pelvic pain or pelvic discomfort
- Bladder problems
- Lower back pain
- Rectal pressure
- Uncomfortable sex or Painful sex
You may also notice other symptoms along with the ones mentioned above:
- Weight gain
- Having menstrual-type cramps outside your menstrual period
- Unusual discharge
- Foul-smelling vaginal discharge
- Pelvic pain
- Frequent urination or difficulty in passing urine
Some other symptoms of cervical cancer are :
- Abnormal bleeding
- Abnormal vaginal discharge with a foul odor
- Lower back pain
- Unexplained weight loss
- Pain and swelling in legs
- Decreased appetite
- Pain during sex
3. Thing You Should Be Asking Yourself If You Experience Spotting Before Periods
- Is my menstrual cycle happening regularly?
- Do I have any unusual menstrual symptoms?
- Am I sure of the reason behind my unexpected spotting before my period?
- For how long is my unexpected or unexplained spotting or bleeding lasting?
- Is there anything that is causing the bleeding to get worse?
- Am I taking my medications at the right time?
- Am I eating healthy?
- Am I practicing healthy and protected sex? (If you are sexually active or have multiple sex partners.)
Spotting before period, though quite common, sometimes may indicate that something is out of balance and wrong inside your body. Get yourself examined medically and contact your healthcare provider to know its exact cause. This may help prevent you from having some serious health-related problems or harmful diseases like cancer.
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