What Is Spotting and What Does Spotting Look Like?

What Is Spotting and How Spotting Looks Like
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Spotting is light bleeding that can look like the start of your regular menstrual period but happens before or after your period. Although you may be worried about light vaginal bleeding between your monthly periods, there usually isn’t anything to worry about. Spotting looks like small dark brown spots or light pink marks on your underwear which makes it possible to tell apart from regular menstrual bleeding.

Some occasional light spotting between your periods is viewed as normal and can be caused by stress, using birth control, or even a sign that ovulation has occurred. In fact, implantation spotting before your period is due could be a sign that you are pregnant. However, there are some conditions where vaginal spotting when you don’t have your period can be a cause for concern. Uterine fibroids, ovarian cysts, infections, and cancer can cause light to heavy vaginal bleeding and may be associated with abdominal pain, fever, and pain during bowel movements. Some spotting can occur during pregnancy and you should always speak to your doctor or obstetrician about the bleeding.

In this article, you will learn about what spotting looks like and how to tell the difference between period bleeding and spotting. You will also find out when spotting is considered normal and when you should speak to your doctor about abnormal vaginal bleeding.

What is Spotting?

Spotting is referred to by doctors as abnormal vaginal bleeding. According to staff from the Mayo Clinic, spotting is when you notice small amounts of blood when you are not expecting your period. The spots of blood are often seen after wiping when you have used the bathroom or you may notice them on your underwear.1

According to Dr. William Blahd on WebMD, light spotting has many causes and doesn’t necessarily mean that you have a serious condition. For example, Dr. Blahd says that some light bleeding can happen with ovulation and even in pregnancy, and some minimal spotting can be considered normal.2

Spotting vs. Period – How to Tell the Difference

Knowing what spotting looks like and when it happens can help you tell the difference between regular menstrual flow and spotting. For some women, spotting can be the first sign that their menstrual period has started. So, telling spotting apart from regular menstrual bleeding requires that you observe and know what is normal with your monthly cycle.

What is considered a light period?

Having your period marks the start of your regular menstrual cycle. According to Dr. Traci Johnson on WebMD, what is considered “normal” depends on each woman and their menstrual cycle. In general, a light period is one where bleeding lasts a short time and the blood flow is relatively light. For example, some women have very light periods that only last 2-3 days with light blood flow.3 Light blood flow might be as little as 10 ml, or 2 teaspoons, of blood lost during the period.4

However, even a longer period where bleeding occurs for around 5 days and is heavy, is also “normal” for some women.

What Does Spotting Look Like?

Before we look at the conditions that can cause spotting, there are some ways to identify spotting and recognize any accompanying symptoms.

Blood flow associated with spotting

Blood flow associated with spotting will generally be very minimal. For example, the American Pregnancy Association says that spotting that is associated with implantation bleeding may last from a few hours up to 2 days.5 Other conditions may cause regular spotting between your periods such as using birth control or ovulation.

Color of spotting

One way to know what spotting looks like is to look at the color of spotting. Blood that isn’t a result of menstruation is usually a different color from regular menstrual bleeding. Because blood from spotting is generally older than menstrual blood, spotting may be a darker, brown color that looks like rust marks or spots on underwear. Other causes of spotting may cause a lighter, pinkish color and may or may not be accompanied with discharge.

Spotting during menstrual cycle

Spotting in the middle of your menstrual cycle may be a normal occurrence for many women. According to the American Journal of Epidemiology, mid-cycle spotting can happen at the same time as ovulation and may cause light bleeding for 1 or 2 days.6

Other symptoms of spotting

Along with light pink or dark brown spots occurring occasionally between periods, some conditions can cause other symptoms. For example, Dr. Jacqueline Payne on Patient.info says that you may experience some abdominal pain or cramping and suffer from general pelvic discomfort. Or, infections can cause itching or vaginal discharge along with the abnormal vaginal bleeding.7

Signs of Period Bleeding

In order to know what spotting is and what it looks like, you should get to know your own monthly cycle. This will help you recognize any abnormal or unusual bleeding that could require a visit to your doctor.

Although some women have spotting at the onset or end of their period, menstrual bleeding is not the same as spotting.

The frequency of period bleeding. Even if you have irregular periods, menstrual bleeding follows a cycle. Doctors from the Mayo Clinic say that the menstrual cycle can last from 21 to 35 days in length, with 28 days being the average.8

Menstrual bleeding pattern. Bleeding that happens in time with your period usually starts as very light bleeding or spotting and gradually gets heavier. The American Journal of Epidemiology reported that during the first 3 days women experience regular heavier bleeding. This gradually becomes lighter and the bleeding last on an average of 5 days.6

Premenstrual symptoms. About a week before your period is due, hormonal changes in your body can cause certain premenstrual symptoms. Doctors from the Cleveland Clinic say that some of the more common symptoms of menstruation are cramping in the abdomen and lower back, moodiness, food craving, tender breasts, and outbreaks of acne.9

Spotting During Pregnancy – Is It Normal?

One of the first visible signs of pregnancy in many women is implantation bleeding. Spotting in early pregnancy happens when the fertilized egg attaches itself to the uterus lining. According to Dr. Trina Pagano on WebMD, implantation bleeding usually occurs from 6 to 12 days after conception and it lasts for up to 2 days.10

Not all women who are pregnant experience implantation bleeding and for some who do, the spotting could be so light that it is hardly noticeable. Dr. Traci Johnson on WebMD says that some women mistake implantation spotting with a light period that lasts a few days.11

Around about this time you may notice that your breasts start getting bigger and you may also notice bumps around your areola as your Montgomery glands become enlarged and you get tired easily. In time, you may start experiencing nausea and vomiting (morning sickness) and an increased urge to pee as the first signs that you are pregnant.

Many women are, of course, concerned if they notice spotting during their pregnancy. According to the journal Annals Epidemiology, many causes of vaginal bleeding during pregnancy are not serious. Researchers found that about two-thirds of pregnant women experience some spotting and light bleeding during pregnancy. Usually, the pregnancy spotting lasted between 1 and 3 days.12

However, because bleeding during pregnancy can also be a sign of miscarriage, you should talk to your obstetrician about any bleeding, especially if it is heavy.

What pregnancy spotting looks like

Pregnancy spotting looks like light spotting that has a pinkish or dark brown look to it. According to Dr. Nivin Todd on WebMD, spotting associated with pregnancy is lighter in color than regular menstrual blood that happens at the start of the menstrual period. Usually, implantation spotting is noticed before you start suffering from nausea and other pregnancy symptoms.13

Causes of Spotting

Now that you know what spotting is and how spotting looks like, let’s look briefly at some of the main causes of mid-cycle spotting. As you will see, some light bleeding before your period or after your period can be classed as normal and nothing to worry about.

Ovulation

A common cause of spotting that is harmless between your monthly periods is ovulation. This type of spotting looks like very light pink discharge or blood. According to Professor Dr. Andrew Kaunitz at the Department of Obstetrics and Gynecology at the University of Florida, fluctuation in hormone levels can cause light vaginal spotting at the time of ovulation. Spotting is also common in women who have irregular ovulation patterns.14

Birth control

Certain birth control methods can also be a reason for spotting with no period. Doctors from the National Health Service report that oral contraceptives can be to blame for irregular bleeding when you don’t have your period. This is especially noticeable in the first 3 months of using oral contraceptives.14 Also, intrauterine devices can cause spotting in the weeks after insertion. However, in time the spotting due to birth control should normalize.16

Stress

Stress can play havoc with your hormones and cause spotting and light bleeding when you don’t expect your period. The Journal of Family Practice found that psychological stress can be connected with irregular vaginal bleeding. Researchers were able to identify that personal stress was to blame for some cases of abnormal uterine bleeding.17

Implantation bleeding

Another common reason for noticing evidence of spotting before your periods is implantation bleeding. Although not all women who become pregnant show signs of spotting, the National Institutes of Health report that about one-quarter of pregnant women have some form of light spotting that resembles rusty-colored marks on their underwear.18

Sexual intercourse

Sometimes you may notice spotting marks on bed-sheets after sexual intercourse. According to Dr. Traci Johnson on WebMD, there can be many reasons for light spotting after being intimate with your partner. Some of these reasons for spotting after sex are inflammation of the cervix, cervical polyps, friction during intercourse, or genital sores. If you frequently notice spotting after sex, you should visit your doctor for a checkup.19

Ovarian cysts

Ovarian cysts can cause abnormal vaginal bleeding and are one of the reasons not to ignore spotting after your period. Dr. Irina Burd from Johns Hopkins University School of Medicine says that ovarian cysts can cause spotting as well as pelvic cramping, bloating, and painful bowel movements.20

You can read more about the types of ovarian cysts and their warning signs in my article about ovarian cysts – warning signs you should not ignore.

Uterine fibroids

Small growths on your uterus called uterine fibroids can cause light vaginal bleeding when you don’t have your period. Dr. Melissa Conrad Stöppler on MedicineNet says that fibroids in your reproductive system can cause bleeding, pain in the abdominal area, and possibly the need to empty your bladder frequently.21

A similar condition is uterine polyps that can also be a reason for frequent spotting between your periods. You may also notice that your periods become heavier if you have uterine polyps. You can find more information about uterine fibroids in my article about 7 warning signs you may have uterine fibroids.

Hypothyroidism (underactive thyroid)

Hypothyroidism describes a condition where the thyroid gland doesn’t produce enough thyroid hormone. Usually, an underactive thyroid gland causes fatigue, hair loss, and a slower metabolism. However, a study published in the International Journal of Recent Trends in Science and Technology found that hypothyroidism is connected with irregular vaginal bleeding and can cause heavier periods than normal.22

Perimenopause

If you are approaching the menopause you may notice more irregularities with your menstrual cycle and increased episodes of vaginal spotting. According to the American College of Obstetricians and Gynecologists, fluctuations in hormone levels in the months leading up to the menopause can cause spotting and abnormal bleeding.23

Any vaginal bleeding after you have gone through the menopause should be reported to your doctor as this can be a sign of more serious conditions.

Pelvic inflammatory disease

An infection in your vagina can cause spotting without having your period. The Centers for Disease Control and Prevention says that pelvic inflammatory disease (PID) is often transmitted through sexual contact, however, other infections can also cause PID. The common symptoms of PID include bleeding between your periods, experiencing spotting after sexual activity, and a painful burning sensation when you urinate.24

Cancer

Vaginal bleeding is one sign of uterine cancer. Doctors from the National Health Service say that the signs may start off as light spotting and get heavier over time. However, in most cases, abnormal bleeding isn’t a sign of cancer but any vaginal bleeding after the menopause is considered abnormal and you should speak to your doctor about it.25

You can find more information about uterine cancer in my article about uterine (endometrial) cancer – symptoms, risk factors and prevention.

Spotting – When to See a Doctor

Thankfully, most cases of spotting that you notice on your underwear or toilet tissue after wiping are nothing to worry about. According to doctors from the Mayo Clinic, the best way to know if your spotting is normal or not is to keep track of your menstrual cycle. This helps you know how to recognize spotting and tell it apart from regular menstrual bleeding. You should record the heaviness of your flow and any pain or abnormal bleeding you experience.26

Doctors generally recommend making an appointment with your doctor for irregular or abnormal spotting in the following circumstances:27

  • You are postmenopausal and notice any kind of vaginal bleeding.
  • You are pregnant and have unusual bleeding that is light to heavy.
  • You have signs of a vaginal infection like swelling around the labia, itching, smelly discharge, or a fever.
  • You have concerns about what your spotting looks like or irregular vaginal bleeding.

Read my other related articles:

Article Sources

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  2. WebMD. Abnormal vaginal bleeding.
  3. WebMD. What is normal menstrual period?
  4. CEMCOR. Very heavy menstrual flow.
  5. AmericanPregnancy. Implantation bleeding.
  6. Am J Epidemiol. 2012 Mar 15; 175(6): 536–545.
  7. PatientInfo. Vaginal discharge and vaginal bleeding.
  8. MayoClinic. Menstrual cycle.
  9. ClevelandClinic. Normal menstruation.
  10. WebMD. Pregnancy symptoms.
  11. WebMD. Bleeding during pregnancy.
  12. Ann Epidemiol. 2010 Jul; 20(7): 524–531.
  13. WebMD. What is implantation bleeding?
  14. UpToDate. Abnormal uterine bleeding.
  15. NHS. What causes bleeding between periods?
  16. J Obstet Gynaecol (Lahore).1983 Oct;4(2):127-8.
  17. J Fam Pract.1983 Dec;17(6):999-1003.
  18. NIH. Some common signs of pregnancy.
  19. WebMD. Bleeding after sex.
  20. MedlinePlus. Ovarian cysts.
  21. MedicineNet. Benign uterine growths.
  22. Int J Recent Trends Sci Tech. 2015;14(1):131-135.
  23. ACOG. Perimenopausal bleeding and bleeding after menopause.
  24. CDC. Pelvic inflammatory disease.
  25. NHS. Womb cancer – symptoms.
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  27. MayoClinic. Vaginal bleeding.
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