spottingVaginal bleeding between menstrual periods — what most of us call spotting — is a common problem. Almost every woman will experience it at some point in her life. Normal menstrual flow lasts about 4 days (plus or minus 2 – 3 days). It produces a total blood loss of 30 – 80 ml (about 2 – 8 tablespoons), and occurs normally every 28 days (plus or minus 7 days).

Any vaginal bleeding that occurs after a menstrual period ends and before the next period starts is considered spotting. The bleeding may be so light that you only notice a faint pinkness on toilet paper or your underwear, but it also can appear as a drop or two of blood or even a heavier flow that may resemble your period.

There are many different causes of bleeding between periods. In most cases, spotting before your period is no cause for concern. Some may not be anything to worry about, but seek medical advice if you’re concerned.

CAUSES
Hormonal contraceptives: Irregular bleeding, such as bleeding between periods, is common during the first three months of starting hormonal contraception, such as the:

  • combined oral contraceptive pill
  • progestogen-only contraceptive pill
  • contraceptive patch (transdermal patch)
  • contraceptive implant or injection
  • intrauterine system (IUS)

Other common causes for abnormal vaginal bleeding between periods include:

  • Vaginal dryness, especially with the onset of menopause
  • Injury of the vaginal opening such as during sexual intercourse
  • Inflammation or infection of the cervix
  • STI’s such as chlamydia, or gonorrhoea
  • IUD use (may cause occasional spotting)
  • Ectopic pregnancy
  • Miscarriage
  • Stress
  • Uterine polyps
  • Polycystic ovary syndrome (PCOS)
  • Thyroid disorders
  • Diabetes
  • Endometriosis or other changes in the endometrium
  • Bladder or vaginal infections
  • Pregnancy

What to Do About Spotting Between Periods
If you’re concerned about your bleeding, you should see your Doctor. A healthcare professional will talk to you about your symptoms.

Even if your vaginal blood spotting doesn’t signal a health problem, there’s no reason to put up with the inconvenience of spotting before your period. Spotting during one cycle isn’t really a cause for alarm, but if the spotting becomes regular, we recommend you see your medical provider.