Spotting vs. Period: How to Tell the Difference

Is it spotting or your period?

• Spotting refers to very light vaginal bleeding or brown discharge that occurs between menstrual periods.
• Menstrual periods are the monthly bleeding that occurs in women of reproductive age.
• Spotting may be due to a number of causes. You should call your doctor or other health care professional if you are pregnant and experience spotting or bleeding of any kind.
• Is spotting a sign of pregnancy? Implantation bleeding in early pregnancy is a common cause of spotting and is not abnormal.

What does spotting look like?

Spotting is light vaginal bleeding with a small amount of blood that may vary in color from pink to red to brown. It is usually lighter in flow than a regular period, does not require a pad or tampon, and can be detected as a few drips on toilet paper or a pantyliner. The blood may be thinner and mixed with cervical mucus, giving it a lighter or watery look. Spotting can occur at any point during the menstrual cycle and typically lasts a few hours to a few days.

Spotting is more likely to occur in certain women who:

• Are approaching menopause
• Are pregnant
• Have switched birth control methods, including having a new IUD in place or having recently started taking birth control pills
• Have infections of the sex organs including STDs and pelvic inflammatory disease (PID)
• Have fibroid tumors of the uterus or cervical polyps
• Have polycystic ovary syndrome

Spotting has a number of medical causes, ranging from harmless to potentially serious:

• Implantation bleeding: Many women experience spotting in the early weeks (first trimester) of pregnancy. Implantation bleeding is a common cause of spotting. This occurs early in pregnancy when a fertilized egg attaches to the wall of the uterus (known as implantation). A woman may mistake this light implantation bleeding for a menstrual period and therefore not realize she is pregnant.
• Pregnancy spotting: Pregnancy spotting is light vaginal bleeding with small amounts of blood, ranging in color from light pink to light rust, in contrast to period blood which is bright to dark red. Though it is usually caused by implantation, it may occur anytime during pregnancy. Unlike period blood, pregnancy spotting does not contain any clots and does not continue as a heavy flow period. It usually occurs about 10 to 14 days following conception and lasts a few hours to a few days.
• Birth control: Certain birth control methods can cause spotting, including birth control pills, especially when they are first used. Switching birth control pills or continuously using birth control pills can also cause spotting. Some women with an IUD (intrauterine device) for birth control also report spotting.
• Polycystic ovary syndrome (PCOS) is a common condition in which multiple cysts form in the ovaries. It can make it difficult to get pregnant and can cause irregular periods and bleeding.
• Benign growths in the uterus or cervix, like fibroids or cervical polyps, can cause irregular bleeding and spotting.
• Infections, including sexually transmitted diseases (STDs), are another possible cause of spotting or breakthrough bleeding in between periods.
• The menopausal transition is a time when women’s hormone levels can vary widely, sometimes causing spotting or irregular periods.
• The trauma of any kind, including assault or rough sex, can injure the vagina and lead to bleeding or spotting.
• While the vast majority of spotting in pregnant women is not due to serious causes, spotting and bleeding in early pregnancy are sometimes related to miscarriage or ectopic pregnancy (a pregnancy that has been implanted outside the womb or uterus, most commonly in the Fallopian tube).

If you have continuous spotting, abnormal vaginal bleeding, or spotting postmenopausal you need to be evaluated by a doctor or other health care professional. Any pain associated with spotting should be evaluated.

Menstruation or the menstrual period refers to the monthly vaginal bleeding that is experienced by women of reproductive age. Most women recognize their menstrual period. The typical menstrual cycle lasts 28 days. The menstrual bleeding is heavy enough to require the use of a pad or tampon and lasts for 3-5 days on average. Menstruation stops during pregnancy.

Here’s how to know if it’s spotting or period:

• To distinguish between your period and spotting, you should observe the blood's flow, color, timing, duration, symptoms, and consistency. Spotting is typically very light, with only a few drops of pink, red, or brown blood visible on toilet paper or a pantyliner. In contrast, a period involves a heavy flow of blood that requires the use of pads or tampons.
• Spotting usually lasts a few hours to a few days and can happen any time during the menstrual cycle, often around ovulation or due to hormonal changes, stress, or implantation in early pregnancy. On the other hand, a period typically follows a regular cycle (every 21 to 35 days), lasts three to seven days, and is often accompanied by cramps, bloating, and mood changes. Period blood tends to be thicker and may contain clots, while spotting is thinner and may be mixed with cervical mucus.

Symptoms of a period (menstruation)

• Cramps in the abdomen, pelvis, or lower back
• Bloating or slight weight gain
• Tender, sore breasts
• Mood swings
• Headache
• Fatigue

Symptoms of spotting

Spotting usually is much lighter bleeding than normal menstrual bleeding. Unlike a normal period, it usually is so light that a pad or tampon is not required. Spotting may be red or brown in color and occurs when you are not having your regular period. Spotting may not have any symptoms associated with it, but if it happens as a result of a medical condition, you may have other symptoms like:

• Heavy bleeding during the menstrual period
• Irregular periods
• Abdominal pain
• Burning or pain during urination
• Pain or burning during sexual intercourse
• Vaginal discharge, redness, or itching

The cause of vaginal bleeding or spotting requires a thorough history of the symptoms (when the bleeding or spotting is occurring and any associated symptoms, birth control methods, difference to regular period, and history of any medical conditions or infections).

• A pelvic examination is usually the first step to diagnosis.
• A pregnancy test is performed for women of reproductive age.
• Special tests like a Pap smear or cultures may be ordered.
• In some cases, blood or urine tests are ordered.
• Imaging studies such as vaginal or abdominal ultrasounds may be useful in diagnosing the cause of spotting or bleeding.

Treatments for spotting depend on the underlying cause of the spotting.

• Many causes of spotting are not serious, and there is no treatment required.
• For infections, antibiotic therapy is indicated.
• Women with PCOS who desire to become pregnant can be treated with fertility-enhancing drugs or assisted reproductive technologies.
• Surgery can be required in some cases to remove cervical polyps or uterine fibroids that are causing bleeding.
• For women who desire a more regular menstrual cycle, sometimes birth control pills or hormonal treatments can be helpful.

Talk to your doctor or other health care professional if you are not sure if it is your period or if you are spotting.

Remember, spotting is light bleeding that does not get heavier like a typical menstrual period. The normal menstrual period usually is associated with some other symptoms like breast tenderness or cramps as described previously, and often is accompanied by a heavy flow. During the first day of your period, bleeding may be light, but it typically becomes heavier over the next few days.

Light bleeding that does not worsen and is not associated with the symptoms of your period is likely to be spotting.

A home pregnancy test can be helpful if you believe you are spotting due to early pregnancy, or you may experience early signs and symptoms of pregnancy.

You should always contact your doctor or other health care professional if you experience any vaginal bleeding, spotting during pregnancy or after menopause, or any time you have unusual bleeding that concerns you.

• Why am I spotting before my period? The most common cause of spotting before your period is hormonal imbalance, such as a decrease in progesterone levels before menstruation or due to hormonal birth control usage. Other causes may include:
  • Implantation bleeding, which is an early sign of pregnancy
  • Stress
  • Infections such as STIs
  • Polycystic ovary syndrome (PCOS)
  • Fibroids
  • Endometriosis
  • Thyroid issues
  • Physical changes in the cervix
  • Intense physical exercise
  • Certain medications, such as blood thinners
  • Certain injuries
  • Cancer
• Why am I spotting after my period? Spotting after your period can be caused by various factors such as residual menstrual blood, hormonal changes, the use of hormonal contraception, or hormonal replacement therapy. Other causes include vaginal or cervical infections such as STIs, noncancerous growths including uterine polyps or fibroids, PCOS, endometriosis, or perimenopause. Implantation bleeding or pregnancy complications such as ectopic pregnancy or miscarriage may cause spotting. Certain health conditions such as blood clotting disorders, liver disease, thyroid issues, and cancer can also cause spotting.
• What does spotting look like? Spotting appears watery and thinner than normal period blood. It is usually mixed with cervical mucus, resulting in lighter colors ranging from pink to red to brown co.
• How much blood is considered spotting? Spotting is lighter than normal period, with very small amounts of blood, usually a few drops or light streaks, which do not require menstrual products like pads or tampons.
• What is period spotting? What is spotting instead of a period? Period spotting is light bleeding in small volumes that occurs at the start or end of a menstrual cycle, and the blood flow is slower than the regular period. Spotting is mild bleeding that occurs before the actual period flow starts or anytime between the cycles.
• What is spotting but no period? Why am I spotting two weeks after my last period? Spotting without a period is mild bleeding that may occur in between your regular periods but is not followed by the typical blood flow of a period. The most common cause of spotting two weeks after your previous period is hormonal changes that occur during ovulation.
• How many days is spotting before period? Spotting before a period may last anywhere from a few hours to a few days, with most cases occurring one to two days before the menstrual flow begins.
• What does spotting instead of period look like? Unlike a usual period, spotting is light bleeding with small drops of blood, which may range in color from pink to red to brown.