Spotting before your period is often unexpected and can be inconvenient. Light bleeding or staining is often a sign of harmless hormonal changes, so there is usually no need for concern or embarrassment. In fact, health experts say that intermenstrual bleeding is experienced by many women at some point in their lives.
But there are some situations where pre-period spotting warrants a call or a visit to your healthcare provider. Learn what to look for if you're worried about spotting and what you can do if it interferes with your life.
What Does Spotting Before Your Period Mean?
According to the American College of Obstetricians and Gynecologists (ACOG) spotting between your periods is considered abnormal uterine bleeding (AUB). It doesn't matter if you're spotting 5 days before your period, spotting 2 days before your period, or even spotting 2 weeks before your period. Abnormal uterine bleeding is defined as any bleeding from the uterus in a woman that is not pregnant that varies from what is normal.
Abnormal uterine bleeding also includes bleeding or spotting after sex, heavy bleeding during your period, and menstrual cycles that are longer than 35 days or shorter than 21 days.
Spotting 1-2 Days Before Your Period
While the term "abnormal uterine bleeding" may sound alarming, experts say that there is usually nothing to be worried about. According to Mary Jane Minkin, M.D., a clinical professor at Yale University, many women will spot before their periods. She says that the significant majority of the time, it is just that the woman hasn't ovulated very well that month.
"When we ovulate, we make progesterone, which is the hormone that prepares the lining of the uterus for a fertilized egg," she says. "And it's quite common that if one doesn't ovulate perfectly and make a good amount of progesterone that cycle, that spotting will start a day or couple of days before the true period. It is a nuisance, but not worrisome."
Spotting Throughout Your Cycle
If spotting happens several days or even weeks before your period, you may want to make note of it. A regular pattern of mid-cycle bleeding might warrant a call to your healthcare provider.
Dr Minkin explains that when you spot or bleed lightly at any random point during your cycle there is more concern that the spotting might represent a polyp, or (very rarely) a precancerous condition of the lining of the uterus or cervix. She adds, however, that, in young women this would be extremely rare.
"If (spotting) happens once, and never again, it is very very unlikely that it would represent anything serious. But if it does happen regularly, you do want to check in with your gynecologist."
Other Causes of Spotting
In some cases, spotting can indicate that something other than a typical hormonal change is happening. ACOG lists several potential causes of spotting in women:
- Fibroids or polyps: These noncancerous growths may be found on the cervix or uterus and both can cause irregular or heavy menstrual bleeding.
- Hormonal disorders: Conditions including polycystic ovary syndrome (PCOS) and hypothyroidism can cause irregular bleeding.
- Menopause or perimenopause: It is normal for your periods to change when your body is approaching menopause because your ovaries begin to make less estrogen. Usually, this begins to happen in your 40s. According to ACOG, it is normal to have spotting during this time, but you should talk to your gynecologist if you are concerned about abnormal bleeding.
Spotting along with heavy bleeding or pain can indicate other medical conditions such as endometriosis, adenomyosis, a bleeding disorder, or cancer. A physical exam (including a pelvic exam), lab tests, and other diagnostic procedures will help your doctor determine the cause of the abnormal bleeding.
What to Do About Spotting
Unexpected vaginal bleeding can be uncomfortable. If you're not prepared, it can lead to staining on your clothes or other inconveniences. While there is no need to feel shame or embarrassment (periods are a natural part of being a woman!) there are things you can do about spotting if it interferes with your life.
Consider Birth Control Pills
Dr. Minken advises that if the preperiod bleeding is annoying, it is very easy to treat. She says birth control pills will almost always straighten it out.
Birth control pills, also called oral contraceptives, are the most commonly prescribed form of contraception in the U.S.. The pills are primarily used to prevent pregnancy but can also be helpful to manage spotting.
There are three types of birth control pills: combined estrogen-progesterone, progesterone-only, and continuous or extended use pill. Each type of birth control pill inhibits ovulation to prevent pregnancy. The most commonly prescribed pill is the one that contains both estrogen and progesterone. Experts explain that progesterone is a hormone that prevents pregnancy and estrogen is a hormone that controls menstrual bleeding.
However, bleeding can occur while on a birth control pill. In fact, studies have suggested that unscheduled bleeding is one of the main reasons that women cite for discontinuing their birth control. But Dr. Minken explains that erratic spotting or light bleeding while on a birth control pill is usually not a problem. She said that break-through bleeding can usually be managed by switching to a different pill.
Make Lifestyle Changes
There are some women who are at higher risk for spotting or breakthrough bleeding while on birth control. For instance, having an infection (such as chlamydia or gonorrhea) can put you at higher risk. In addition, women who don't take their birth control pills consistently are also more likely to experience irregular bleeding. Getting on a regular routine so that you take your pill at the same time each day can help if you are spotting while on birth control.
Also, if you are a smoker, you may want to consider quitting. Smoking while on hormonal birth control puts you at higher risk for spotting before your period or breakthrough bleeding.
Talk to Your Doctor
If spotting before your period-or at any time during your cycle-causes you concern, your healthcare provider can offer you the best personalized advice. Remember that it is okay to visit your gynecologist on your period. The Cleveland Clinic reminds women that doctors are used to examining women who are bleeding so there is no need to feel embarrassed. Having a frank conversation about your menstrual concerns can help you to get the answers you need.
Banish Shame and Embarrassment
The organizers of National Menstrual Hygiene Day (May 28) say that 42% of women have experienced period-shaming, and that one out of every five felt shame because of a comment made by a male friend. Twelve percent have been shamed by a family member.
Pre-period spotting can be a particular source of shame. Sixty five percent of women say that they have worn specific clothing that wouldn't show a leak if it were to happen and seven in 10 women have asked a friend to walk behind them during their period to check if any period spotting was noticable.
Research has suggested that the stigma of menstruation limits a woman's behavior and compromises her well-being. Experts advise different ways to eliminate the stigma and take steps toward "menstrual justice." They say that simply talking about menstruation can create more positive attitudes and that events aimed at raising women's menstrual consciousness can help facilitate these conversations.
National Menstruation Day is celebrated on 28-5, or the 28th of May, because on average, women and girls menstruate for 5 days per month. On this day, organizers provide educational sessions in schools and promote events to raise awareness and to increase the political priority of the issue. You'll find a list of events on the organizers' website.
FAQs About Spotting Before Your Period
Why do I spot before my period?
In most cases, women of childbearing age experience light bleeding before their period as the result of hormonal shifts during ovulation. Most of the time, it is not reflective of a larger issue. During menopause, women may experience spotting although it may or may not occur before a period.
Is it normal to spot before my period?
Technically, spotting is referred to as "abnormal" uterine bleeding (AUB) by gynecologists. But many women experience it and it is usually not cause for concern.
What if I notice light pink spotting before my period?
Pink spotting is usually just light bleeding. Dr. Minkin refers to it as "light staining" and she says that it can occur a day or two before your period. In young women, she says that it is rarely worrisome.
What if I have brown discharge a week before my period?
Women's health experts say that brown blood is usually older blood that has had time to oxidize. The color of the blood changes as a result. You might see brown blood if your flow is slow or if the blood is left over from your last period.
Can spotting be a sign of pregnancy?
According to ACOG, spotting can occur up to 14 days after you become pregnant (fertilization). They say it can happen after sex or after a pelvic exam and generally occurs in 15-25 out of every 100 pregnancies. Heavier bleeding in early pregnancy can be a sign of infection, ectopic pregnancy, or pregnancy loss.
Dr. Minken advises that if there is any chance that you may be pregnant, it is worthwhile to take a home pregnancy test. She says that tests like First Response will tell you if you are pregnant six days before the first day of the missed period. So if there is a chance you could be pregnant (for example, if you were sexually active and not using contraception) take a home pregnancy test and discuss your results with your healthcare provider if you have any concerns.
Can other types of birth control cause spotting?
Yes, according to gynecologists, breakthrough bleeding can occur with any kind of hormonal birth control, such as the birth control pill but also including the vaginal ring, birth control implant, hormonal IUDs, or a skin patch. But it most commonly occurs with low-dose and ultra-low-dose birth control pills, the implant, and hormonal IUDs.
