Spotting Between Periods

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is spotting between periods?

Spotting happens when bleeding occurs outside the first few days of the cycle. Unlike periods, spotting between periods causes a smaller amount of blood loss. You may only notice blood on the toilet paper or spots on your underwear. In most cases, spotting isn’t anything serious. But it can be a sign of cancer or precancerous conditions. Any time you have bleeding between periods, you should see your doctor promptly.

Spotting between periods is bleeding that occurs in the days between normal menstrual flow. It is a type of abnormal uterine bleeding or abnormal vaginal bleeding. The medical term for it is intermenstrual bleeding.

To understand the difference between spotting and periods, it helps to review a normal menstrual cycle. Bleeding marks the first day of a woman’s cycle. It lasts for an average of five days. Ovulation generally occurs on day 14 of the cycle. If pregnancy doesn’t happen, menstrual bleeding starts again about 14 days after ovulation. This makes the average menstrual cycle 28 days long. However, ACOG (American College of Obstetricians and Gynecologists) states a normal cycle can range from 24 to 38 days.

What other symptoms might occur with spotting between periods?

Depending on the underlying cause, bleeding between periods can occur with other symptoms.

Menstrual-related symptoms that may occur along with spotting between periods

Spotting between periods may accompany other symptoms affecting the uterus and reproductive system including:

  • Cramping, bloating, or abdominal pain or discomfort
  • Heavy bleeding during your period
  • Irregular period length or skipping periods

Other symptoms that may occur along with spotting between periods

The causes of bleeding between periods can trigger symptoms in body systems outside the reproductive system. Numerous other symptoms can occur including:

  • Changes in bowel habits
  • Easy bruising or bleeding in other areas, such as frequent nose bleeds
  • Itching or jaundice (yellow discoloration of the skin and eyes)
  • Thinning scalp hair or extra facial or body hair

Spotting between periods is usually not due to a serious or life-threatening condition. However, in a small number of cases, it can be a sign of cancer or a precancerous condition. See your doctor promptly if you have any bleeding between periods.

What causes spotting between periods?

The most common causes of spotting between periods are related to a woman’s reproductive system. But there can be other reasons it occurs.

Reproductive causes of spotting between periods

Bleeding between periods may arise from conditions in the reproductive system including:

  • Injury or surgery in the reproductive tract
  • Problems with birth control, including intrauterine device (IUD) use and oral contraceptives
  • Noncancerous growths, including cervical polyps and uterine polyps or fibroids

Other causes of spotting between periods

Bleeding between periods can also be caused by problems in body systems other than the reproductive tract including:

  • Stress
  • Systemic lupus erythematosus (SLE)
  • Thyroid and pituitary disorders

Serious or life-threatening causes of spotting between periods

In some cases, bleeding between periods may be a symptom of a serious or life-threatening condition. This is why it’s important to always consult your doctor if you notice any blood between your periods. Potentially serious causes of spotting between periods include:

  • Endometrial—or uterine—cancer
  • Vaginal cancer

Spotting between periods can also be a sign of precancerous conditions of the cervix or uterine lining.

What are the potential complications of spotting between periods?

In most cases, bleeding between periods is easily treatable and resolves without complications. Sometimes, it can be difficult to treat and eventually lead to surgery, depending on the cause. The type of surgery you need can cause changes you need to consider if you are still of child-bearing age. Thoroughly discuss your treatment options if surgery becomes necessary.

In rare cases, spotting between periods can be due to cancerous and precancerous conditions. Failing to seek treatment can have serious, and even life-threatening, consequences in this circumstance.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 1
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Abnormal Uterine Bleeding. American Academy of Family Physicians.
  3. Abnormal Uterine Bleeding. American College of Obstetricians and Gynecologists.
  4. Vaginal Bleeding. Mayo Foundation for Medical Education and Research.
  5. Vaginal Bleeding Between Periods. Mount Sinai.