How to tell if spotting between periods is a problem

There will come a time in most women’s lives when she will experience bleeding between periods or what is called “spotting.”  Spotting between periods can make an unexpected appearance and when it does, a woman will question why this is happening and it she should worry. 

Usually the cause of spotting tends to be benign, especially if it occurs very infrequently.  However, spotting between periods is never considered a normal thing to happen.  If it is considered abnormal, then what is causing it to happen?  Here are the main reasons why some women may have spotting between periods:

·      Ovulation

Ovulation refers to the process where a matured egg is released from the ovary and typically occurs during the middle of a woman’s menstrual cycle or about between the 11th and 21st day of their cycle.  Some women may notice or be aware of slight pain in the middle of their abdomen which is near where the ovary is located.  The area where the egg passed from the ovary along with the hormones of estrogen and progesterone involved in the menstrual cycle will cause changes to occur within a woman’s reproductive organs that may result in some minor spotting.  For some women, they may experience spotting every month when ovulation happens, while for others, they may hardly ever have this occur. 

·      Contraception

For women who are using birth control pills, hormonal IUDS and patches, shots and implants, spotting between periods can be a common side effect of these hormonally based contraceptives.  It is not unusual for a woman who begins using hormonally based contraceptives or shortly after stopping their use, to have some spotting. Any woman experiencing “break through bleeding” every month, should let her doctor know to help her find a new method of birth control.

·      Pregnancy

Spotting during pregnancy can happen in some women, especially during the first few months.  Any woman noticing spotting when pregnant needs to contact her doctor right away to rule out the possibility of an ectopic pregnancy or other serious condition needing addressed.  Generally, if it is a healthy pregnancy and the spotting is minor and no other problem has been found, it most likely is of no concern. 

·      Menopause

Women, who are going through the change of life of perimenopause to menopause, will have hormonal imbalances occurring that can result in spotting between periods.  Typically, ovulation occurs during the middle of a cycle, with menstruation occurring about 2 weeks later.  During perimenopause, hormone levels may not follow this regular pattern.  As a result, a woman may have irregular bleeding or spotting.  A woman may have two “normal” months of regular periods, followed by going for two or three months without a period, followed by having a period that lasts longer and is heavier than usual. 

When should a doctor be notified of spotting between periods?

For some women, spotting may happen regularly but if can also be a sign of a larger problem.  Many serious conditions are associated with spotting such as miscarriage, ectopic pregnancy, thyroid issues, cancer, uterine fibroids or polyps, ovarian cysts and cervical or uterine cancer.

Women should always inform their doctor if they are experiencing bleeding or spotting between periods so they can help explain the cause or to catch a more serious condition as early as possible.   It’s important to track when spotting is happening and any other symptoms to share with their doctor.  If irregular bleeding is associated with other symptom such as easy bruising, dizziness, fever, abnormal vaginal discharge or abdominal/pelvic pain, a woman needs to see her doctor right away.  They most likely will perform a pelvic exam, obtain cultures or order blood tests or imaging to take a closer look to figure out what is the cause of the abnormal bleeding.