Spotting Before a Period: 7 Causes & When to Worry

June 2022

Spotting is vaginal bleeding that occurs outside of your regular period. This type of bleeding is generally in low quantities, occurs between menstrual cycles, and lasts for about 2 days.

Spotting is considered normal after vaginal exams, or after recent birth control changes. Neither of these situations require treatment and they do not indicate any health issues.

Bleeding outside of a period, however, may be a sign of pregnancy, especially if it occurs 2 to 3 days after unprotected sex. It may also be a sign of pre-menopause which occurs in women over the age of 40.

Common causes

The most common causes of spotting include: 

  • Stress:Stress can provoke hormonal fluctuations, and can be treated with relaxation exercises or aromatherapy. 
  • Change in birth control: This is considered to be a normal reason for spotting outside of a period, therefore you should just monitor it until your body adjusts. If spotting is prolonged, you should see your gynecologist to assess whether your spotting is related to the birth control change. 
  • Uterine polyps:  These are more common in women undergoing menopause. They occur due to the excessive growth of the cells of the uterine lining. They do not always require treatment, only if there is a suspicion for malignancy.
  • Polycystic ovarian syndrome: This is characterized by the presence of various cysts on the ovary. It occurs due to a hormonal imbalance and is treated as indicated by the gynecologist, usually with the use of birth control.
  • Thyroid problems: They occur due to a dysfunction in the production of several hormones. It can result in spotting outside of the period. To relieve thyroid-related problem, you can increase your consumption of foods with iodide, zinc and selenium to help regulate it. 
  • Infections: Vaginal infections can be caused by parasites, fungus, or bacteria, and they may have been sexually-transmitted. STIs usually will result in bleeding after sex. Depending on the type of infection, the doctor may prescribe medication to treat it. 
  • Following vaginal exams: Some exams can be invasive, like the pap test, and it is completely normal to have some bleeding after. No treatment is necessary.

In addition, other situations that can cause bleeding outside of the menstrual cycle or excessive spotting include ectopic pregnancy or uterine cancer. You should follow your treatment plan as indicated by your doctor if this is the case for you.

To avoid confusing spotting with normal period blood, calculate when your next menstrual cycle will occur:

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Bleeding after sex

Bleeding after sex is not normal, only when it is the very first time and there is tearing of the hymen. If bleeding occurs after sex, you should see your gynecologist for assessment and to diagnose the reason for bleeding.

Spotting may be a sign of a sexually-transmitted infection, trauma from sex, cervical wounds, or from insufficient vaginal lubrication. in addition, a woman can unknowingly have cancer, ovarian cysts, endometriosis, or a fungal or bacteria infection, all which can cause bleeding after sex.

Spotting after sex should be assessed for characteristics such as the quantity of blood and the color (as bright red can indicate an infection or lack of lubrication, while darker brown can indicate spotting that can last for about 2 days).

When to go to the doctor

You should see your gynecologist if you:

  • Are experiencing spotting and your period is not due
  • Have excessive spotting that lasts for over 3 days
  • Have spotting, even in small amounts, that lasts for longer than 3 cycles
  • Experience excessive spotting after sex
  • Experience vaginal bleeding during menopause .

In these cases, the doctor may opt to order diagnostic testing a pap test, ultrasound or a colposcopy to assess the reproductive system and identify whether there are any problems causing the sptting. If necessary, he or she will advise appropriate treatment.

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Edited by Tua Saude editing team in June 2022. Medical review completed by Dr. Sheila Sedicias - Gynecologist in December 2021.
Medical review:
Dr. Sheila Sedicias
Gynecologist
Physician graduated in Mastology and Gynecology by UFPE in 2008 and member no. 17459 of CRM-PE, Brazil.