Spotting at different times in the cycle and particularly before a period starts is a relatively common occurance. However this leads to a great deal of confusion among women, as to whether or not this is a true period bleed.
Firstly, if you are reading this and you do experience regular spotting, it is important to get this assessed by your doctor. Spotting can indicate other medical conditions such as infection, hormonal issues and even pregnancy. Therefore it is important to have this factors ruled out.
What is spotting?
Spotting is any bleeding from the vagina that is not due to a woman’s monthly period. Women who track their cycles, generally become very familiar with their body and can easily tell the difference between bleeding.
The characteristics and causes of spotting can vary from woman to woman, however this may include:
• Irregular timing: Women may spot for a day, stop bleeding, and start again. Some women experience spotting intermittently throughout the month. This is particular the case if a woman suffers from hormonal conditions such as Polycystic Ovarian Syndrome (PCOS)
• Associated with predictable menstrual cycle events: Unexplained spotting is often irregular.
• At ovulation: Spotting can also occur at ovulation. Some women experience a day or two of light spotting every month.
• Implantation bleeding: At the time the fertilised egg implants in to the uterus (around 7 days post ovulation), spotting may occur. This typically lasts for a day or two only.
• May be associated with injury: This may or may not include abdominal pain. A woman may notice spotting after vigorous sexual intercourse or after a cervical smear test.
• Often a different colour from normal menstrual period: Some women spot brown blood. Others find that the blood from spotting is lighter or a different texture.
• Uterine fibroids or polyps: Fibroids within the uterus and polyps either on the cervix or attached to the uterine wall, are relatively common
• May be related hormonal contraception or the copper IUD or IUS: Starting on a new contraceptive method. Or stopping or changing the method might change the amount and timing of bleeding.
• Due to a miscarriage: Miscarriage is very common and in some cases bleeding is the first sign that a woman is pregnant. Some miscarriages are so early that they are mistaken for a particularly heavy and lengthy period.
• A warning sign of infection: Some sexually transmitted infections can cause bleeding whereas some are completely symptomless. Bleeding may be accompanied with abdominal pain. Infection which is left untreated can result in pelvic inflammatory disease (PID). PID is a common cause of fertility problems among women.
How is this different from a period?
A normal menstrual cycle can vary in length from 26-32 days. However some women can have shorter or longer cycles, especially if they suffer from PCOS. Each month, the uterine lining thickens to prepare for pregnancy. If a woman does not get pregnant, the uterus sheds its lining, causing a monthly period.
Characteristics of menstrual bleeding may include:
• A regular schedule: While the length of time between periods varies among women, most women experience periods around the same time each month.
• A predictable bleeding pattern: Every woman’s menstrual bleeding follows its own pattern. It is a good idea to get to know what is normal for you. For many women, a monthly period begins with light spotting, gets heavier for a day or two, and then gets gradually lighter, ending with spotting.
• Bleeding duration: Periods usually last 5-7 days, and never last an entire month.
• A period is often associated with other symptoms: In the week or so before a period, changes in hormones can trigger symptoms, such as breast tenderness, acne and irritability. During a bleed, period pain may also be experienced, along with lethargy.
• Menstrual blood is usually red: The colour can help differentiate a period from spotting. Whilst spotting may occur at the start and end of a true bleed and may be darker or brown in colour, there will always be a few days of fresh red blood.