9 reasons why you may be spotting, from stress to PCOS

• Spotting happens when you have light bleeding in between periods.
• The bleeding is usually light and isn't accompanied by any premenstrual symptoms.
• Some causes of spotting include pregnancy, vaginal tears, hormonal birth control, stress, and more.

Many women experience spotting and in most cases, it's nothing to worry about.

For example, you might experience spotting before your period, during pregnancy or menopause. But spotting might also be caused by more serious issues, like vaginal tears or fibroids. Here are nine reasons why you might be spotting.

What is spotting?

Spotting is any bleeding that happens between your periods, says Taraneh Shirazian, MD, an obstetrician-gynecologist at NYU Langone Health. But sometimes - especially for women with irregular or light periods - it can be hard to tell whether you are spotting or menstruating.

Here are some telltale signs that you are spotting:

• The color of the blood is light red or brown: Period blood is usually a dark red, but the blood shed during spotting is typically lighter in color.
• The bleeding is light: The main difference between spotting and your period is that spotting is very light bleeding, says Shirazian. Whereas you may have to go through a few tampons or pads a day during menstruation, you'll typically only need panty liners when you're spotting.
• You don't have premenstrual symptoms: Periods are typically accompanied by symptoms like breast tenderness, acne flare-ups, and cramps. If you notice that the usual symptoms which typically accompany your period are missing when you are bleeding then you are most likely spotting.
• You're bleeding at an atypical time: The most tell-tale sign that you are spotting is if bleeding occurs anytime before or after your period is supposed to happen.

Reasons why you might be spotting

Spotting is normal and in most cases nothing to worry about. If you are spotting it might be a result of any of the reasons below:

1. Hormonal contraceptives

It's common for women who have just started using hormonal contraceptives such as the combined pill, an implant, or a patch to experience bleeding in between periods in the first few months.

Important: If the bleeding lasts more than a few months, you should speak to your doctor about it. They might consider switching out the hormonal contraceptive for a non-hormonal one like the copper IUD.

You may also experience spotting if you skip a day or two of the pill because your hormone levels will drop, which may trigger spotting.

2. Pregnancy

In the first few weeks of pregnancy, some women might experience what's called implantation bleeding.

Implantation bleeding happens when the fertilized egg attaches itself to the wall of your uterus. This can cause small blood vessels in your uterus to erupt, leading to spotting. Implantation bleeding normally occurs within five to ten days after conception.

However, if you are bleeding heavily during pregnancy this might be a sign of a complication like ectopic pregnancy and you should contact your doctor.

3. Vaginal tears

If your vagina isn't properly lubricated before inserting or taking out a tampon or before engaging in penetrative sex, it can cause small vaginal tears which can make you spot. If you have a vaginal tear, you might also experience some pain.

While most mild vaginal tears will heal on their own, it's advisable to speak to a doctor if the bleeding is excessive or the pain is getting worse.

4. Stress

Extreme physical or emotional stress can cause hormonal imbalances. These imbalances can trow off your cycle and cause irregular bleeding.

"Stress can cause spotting. Sometimes women will notice that in moments of extreme stress, they will experience excess spotting which eventually goes away," says Shirazian.

5. Perimenopause

Perimenopause typically starts when women are in their 40s, but could also occur in the 30s for some. During this time, you can expect your periods to become lighter and more irregular because your usual hormonal levels begin to fluctuate.

6. Uterine fibroids

Uterine fibroids are non-cancerous growths that form on and in the uterus. They range in size and multiple can grow simultaneously.

In some cases they are so small they remain undetectable while in other cases they grow large enough to require surgical removal.

Some common symptoms of uterine fibroids include cramping, heavy periods, pelvic pain, and spotting. If you experience a combination of these symptoms you might have uterine fibroids and should speak to your doctor.

7. Polycystic ovary syndrome (PCOS)

PCOS is a condition that causes your ovaries to produce an excessive amount of male sex hormones. It also causes many small cysts to form on your ovaries and is one of the most prevalent causes of infertility.

Related Article Module: What is PCOS? Symptoms and treatments for polycystic ovary syndrome

Some of the most common symptoms of PCOS are abnormally heavy and irregular periods which might sometimes last for several days, weeks, and even months. People living with PCOS might also experience spotting in between periods.

8. A sexually transmitted disease or infection

Chlamydia and Gonorrhea are two of the most common culprits for unusual spotting in women. Some STDs like herpes and trichomoniasis can also cause a condition known as cervicitis. Cervicitis is an inflammation of the cervix that can cause pain, itching, abnormal vaginal discharge, and spotting.

9. Ovulation

When ovulating, some women might experience light spotting that typically lasts for about a day. The bleeding occurs when the egg is released, which ruptures a small vessel in your ovary. Women who spot when they are ovulating might also experience ovulation pain.

However, if you feel severe pain and excessive bleeding when you ovulate, your doctor might recommend an abdominal and pelvic examination to rule out the possibilities of ovarian cysts or endometriosis.

Insider's takeaway

There are two main causes of spotting:

1. Hormonal: When spotting is caused by hormonal fluctuations during your menstrual cycle like pregnancy or perimenopause.
2. Structural: Typically means there's an area of abnormal tissue in your uterus. These can be cervical or endometrial polyps, fibroids, or cervical erosions.

Spotting is typically nothing to worry about, especially if you are on hormonal contraceptives. However, if you are post-menopausal or it's accompanied by symptoms like pain and fatigue then you should speak to a doctor.

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