Spotting before your period: Causes and what you need to know

You might be expecting your period soon and are instead seeing a small amount of blood that is not quite enough to count as a period, but still enough that it’s noticeable. If so, then you may be experiencing spotting before your period. In this article, we’ll go through what it is, what causes it to show up before your period and at other times, and what you can do about it.

What is spotting?

Spotting is defined as a type of light bleeding from the vagina that doesn’t require sanitary protection [1]. It can be just a few drops and show up as red, pink, or brown spots in your underwear or when you go to the bathroom. Even though it isn’t as much blood as a period, some of us feel more comfortable with a panty liner or similar sanitary protection when we’re spotting.

For many, spotting is simply a routine part of their cycle, while for others, it might be an indication of something more serious. It’s important to know what is normal — and not normal — for your unique cycle pattern and keep track of any other symptoms you might be experiencing at the same time. 

Remember that if you experience any kind of abnormal bleeding, it’s a good idea to talk to your healthcare professional.

Causes of spotting before your period

Spotting can actually happen at any time during your cycle. While it’s quite common to see spotting just before your period starts, or even later — around the time you would expect to get your period — there are lots of different reasons why it might be happening. Let’s check out some of the causes of spotting before your period:  

It’s normal for you

Spotting just before your period is often a normal part of a healthy cycle without any particular cause — or cause for concern. In fact, a study of 116 healthy women found that over 40% of them reported spotting just before the start of their period [2]. This is totally normal and for many of us, it’s just a sign that our period is about to start. Additionally, some periods start out with a lighter flow before ramping up, and that can be hard to differentiate from spotting.

Implantation bleeding

If you’re seeing spotting instead of your period, it’s possible that it’s an early sign of pregnancy around the time of implantation. This is when a fertilized egg attaches to the uterine wall and comes into contact with blood vessels. However, there is currently no strong scientific evidence for this phenomenon.[3] 

There are several different reasons for seeing spotting instead of your period, so it doesn’t necessarily mean that you’re pregnant. The only way to be sure is to take a pregnancy test. 

While pregnancy tests can often show a positive result a few days before your expected period, for some people, an early pregnancy test can show a false negative result. So, it is advised to wait until the first day of your missed period to increase the probability of a correct result. Always check the guidance on the packaging of the particular test you’re using.

Endometriosis

Endometriosis is a condition where tissue that’s similar to the tissue in the uterus grows in areas outside of the uterus where it doesn’t belong. It’s usually associated with severe chronic pelvic pain and heavy periods. However, endometriosis can also cause irregular bleeding in general, including both spotting before your period and other bleeding during other parts of your cycle [4,5].

More causes of spotting

There are a lot of other things that can cause spotting, but which aren’t necessarily synced to a particular time during your cycle (except ovulation). So these things can certainly be a reason you’re spotting before your period, but they can just as well cause spotting during the rest of your cycle. Let’s dive into the list:

Birth control

Breakthrough bleeding is unexpected bleeding (i.e., not your period) that happens while you’re on hormonal contraception. It’s most common in the first three to six months after starting a new method as your body adjusts [6]. If you’re on the pill, things like missing a dose, taking your pills at inconsistent times, or taking the combined pill back to back without breaks l can also be a reason for spotting. 

Other forms of birth control can stop any bleeding altogether, such as the birth control shot or the implant. However, some people may still experience irregular bleeding or spotting while using these methods [7]. It doesn’t affect everyone, but it’s a common side effect. Even the non-hormonal copper IUD can cause breakthrough bleeding [8].

Taking emergency contraception (a.k.a., the morning after pill) can cause spotting, an early or late period, as well as other non-menstrual side effects like dizziness, nausea, and abdominal pain [9].

Ovulation

A small number of us see light mid-cycle bleeding that could be linked to ovulation. If you’re one of the 5% of people who experience this, it could be due to the change in hormones at that point in your cycle, but more research is needed to be sure [10].

Sex

Bleeding after sex can be alarming, but there are a number of reasons it can happen. Spotting after sex can be a sign of infections, inflammation, or polyps (non-cancerous growths in the uterine lining), as well as other conditions [11,12]. 

Vaginal dryness can also cause bleeding after sex — using lubricants can help with this and reduce spotting after sex. Talk to a healthcare professional if you experience any type of unexplained bleeding, including after sex.

It's important to monitor how you feel during intimacy. If you start to feel discomfort, pain, or something else that stops you from enjoying sex for any reason, you should feel able to stop and tell your partner. Continuing to have sex when you don’t enjoy it can put you off it in the future, and it may be a sign that something is wrong, so it’s important not to power through.

Pregnancy

While it may be alarming, light bleeding in early pregnancy is surprisingly common, and is not necessarily a sign of miscarriage [13]. One peer-reviewed study looking at 4,539 pregnancies found that while it was common to experience some form of spotting or light bleeding in early pregnancy, heavier bleeding did tend to be more common in pregnancies that ended in miscarriage [14]. 

It’s always a good idea to talk to your doctor or midwife if you experience any kind of unexpected bleeding during pregnancy.

Puberty

When our bodies reach reproductive age, the hormones that regulate our menstrual cycle come into play. It’s not unusual to experience irregular bleeding or spotting around puberty, but this should become more regular as we get older (until perimenopause) [15]. 

Tracking bleeding can also be particularly helpful during puberty when you may still be unsure of what is a period and what is spotting. It’s a good idea to talk to your healthcare provider to get information about what to expect as your body develops. Be sure to bring up any unexplained vaginal bleeding or cycles that last longer than 90 days [16].

Perimenopause

Just as spotting is usual during our early reproductive years, spotting around the time of menopause is fairly common. Perimenopause is the transition phase from the years of regular menstruation to when you stop getting a period at all after menopause. 

There are a lot of hormonal changes happening, so it’s not surprising that people get irregular periods during this phase. You may experience bleeding at different times in your cycle and the amount of bleeding may vary as well. As well as irregular bleeding, other symptoms of perimenopause include hot flashes, night sweats, and mood changes [17].

As always, it’s good to discuss any changes to your regular bleeding patterns with your healthcare provider.

Stress

You might have heard about cortisol, “the stress hormone”, that your body naturally releases in response to stressful situations. Some cortisol is normal and plays an important role in regulating various bodily functions. 

However, prolonged or elevated cortisol levels due to chronic stress can disrupt other hormones, leading to menstrual changes and negative effects on your health. It can delay your period, cause irregular periods, and/or spotting. Drastic changes to your diet and exercise routines can also be stressful for your body and potentially have these effects as well [18]. More research is needed, but menstrual abnormalities have been linked to self-perceived stress in a study of over 700 women [19].

Trauma

It’s not fun to talk about, but it’s important to know that trauma can be another reason for spotting. Physical trauma can be rough sex — whether wanted or not — or non-sexual injury to the vagina, cervix, or abdomen. The cervix can get irritated or even bruised by an object inserted into the vagina, or an infection [20].

Medication

Some types of medications are linked to spotting, such as blood thinners [21]. If you’re taking any prescription or over-the-counter medication, make sure you’re informed of the potential side effects.

Uterine or cervical polyps

Polyps are abnormal growths that form in the uterus or cervix. They are usually benign, but the risk that they might not be increases after menopause. While this condition can cause heavier bleeding, it can also cause lighter bleeding or spotting, or be symptom-free [22]. Tracking your cycle is a great way to be able to see patterns and figure out if your symptoms aren’t normal for you.

Sexually transmitted infections

There are many different kinds of sexually transmitted infections (STIs) with a variety of symptoms. Some, like chlamydia and gonorrhea, can cause pink or yellow discharge, with pink being more likely if the vagina or cervix is irritated [23,24].

STIs can have mild or no symptoms, so it’s best to get checked regularly if you’re having unprotected sex or have multiple partners. The best way to protect against STIs is to practice safe sex and use barrier methods like the condom or the dental dam. 

Pelvic inflammatory disease (PID)

Certain conditions such as pelvic inflammatory disease can cause bleeding between periods and lead to other problems. PID is a disease that can develop from a sexually transmitted infection (STI) or other type of infection, for example from douching or complications from pelvic surgery [25,26]. Look out for other symptoms such as lower abdominal pain and discomfort when you pee.

Fibroids

Fibroids are non-cancerous growths in or around the uterus that can cause various types of abnormal bleeding, including spotting [27]. This may appear like pink discharge, especially when mixed with cervical mucus.

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a condition that might not show any symptoms, unfortunately, but which can cause irregular bleeding or no period at all. It’s the most common reason for anovulation and therefore a leading cause of infertility, despite the fact that most women with PCOS don’t get diagnosed [28,29].

Thyroid conditions

Your thyroid is a gland that produces thyroid hormone, and it affects many different systems in your body because it helps to control your metabolism. Thyroid conditions — including hypothyroidism and hyperthyroidism — are more common in women than men, and having too much or too little thyroid hormone can cause lighter or heavier bleeding and even affect ovulation [30].

Cancer

While cancer isn’t nearly the most common cause of spotting, it’s important to know that abnormal bleeding is a key symptom of many gynecological cancers. For example, of women diagnosed with endometrial cancer, around 90% experience abnormal vaginal bleeding [31]. 

It’s also common in ovarian, uterine, cervical, and vaginal cancers, which tend to get diagnosed at later stages compared to breast or lung cancer because symptoms are usually more subtle and vague [32]. So talk to your doctor if you experience bleeding that is abnormal for you, pelvic pain or pain during sex, changes in your vaginal discharge, or bleeding after menopause [33]. 

It’s important to note that cervical cancer is almost always caused by the human papillomavirus (HPV), for which there is a vaccine.

Other types of vaginal discharge

Not everything that comes out of the vagina is blood. You may notice changes in cervical mucus throughout your cycle. It can change in color and abundance in the days before ovulation occurs, as this is when you’re most fertile. 

Other types of unusual discharge can be symptoms of infections or medical conditions. Pay attention to the color of your spotting and read up on our post on vaginal discharge colors to learn what to look out for.

Spotting vs. period: how to know

Sometimes it can be tricky to tell the difference between spotting and your period. A menstrual period produces a greater volume of liquid that can be thick or thin. Most people think of period blood as dark red, but it can actually come in different colors. 

Spotting tends to be more watery and contains only a few drops of blood mixed with cervical mucus. The color can range from pink to brown, and this type of bleeding isn’t usually abundant enough to require sanitary protection.

Periods also tend to be regular — on average they arrive every 21 to 35 days [34]. Spotting can happen at any time during your cycle, and is quite common just before your period.

Spotting instead of your period

If you have spotting when your period is due but your period doesn’t come, it’s possible you could be pregnant, have a medical condition, or be experiencing perimenopause. There are other signs of early pregnancy, but you can’t be sure unless you get a positive pregnancy test. If you’re using Natural Cycles to plan pregnancy, the app will prompt you on the best time to test. 

When to see a doctor

If you’re experiencing unexpected, abnormal, or prolonged bleeding, contact your doctor. This is especially true if the spotting is unexplained or accompanied by other symptoms like pelvic pain, swelling, fatigue, or dizziness [34]. While this can feel daunting, it’s important to talk to a healthcare professional to get the diagnosis, treatment, or advice that you need.

Treatment for spotting

Depending on where you are in your cycle, spotting is often perfectly healthy. For example, typically, spotting that happens right after or a couple of days before your period shouldn’t be a cause for concern. If this is a regular part of your cycle pattern that isn’t bothersome, then you don’t need to do anything. 

Sometimes spotting might be explained by something happening in your life, like recent vigorous sex or starting a new medication. If spotting coincides with stressful times in your life, do what you can to ease up and try to do things that calm your nervous system.

If your spotting is breakthrough bleeding due to hormonal birth control, taking ibuprofen (NSAIDs) can potentially help reduce spotting — but be aware that aspirin can prolong it [34].

Breakthrough bleeding shouldn’t last for more than a few months after you start the pill. For other hormonal birth control methods, it may take longer to subside. You can always talk to your doctor about your options — it can help to switch to a different method or try another hormonal method with a different dose [35,36].  

While spotting can be a sign that something’s wrong, it’s important to remember that the spotting itself isn’t the issue. It’s a signal from your body that something else needs treatment. If spotting isn’t normal for you, or if it occurs together with other symptoms, then it’s a good idea to contact your healthcare provider.

Know your normal

Because spotting can be both normal and a sign that something’s wrong, it’s extra important to know what is normal and not — for you. With Natural Cycles, you can track your whole cycle — from spotting and cervical mucus to emotional changes and painful symptoms (plus the fun stuff too!). In the calendar, you’ll see when the algorithm predicts your next period will be, which can help you to know where in your cycle you might be spotting.

Whether your goal is to prevent or plan a pregnancy, using Natural Cycles gives you a detailed record to look back on, notice patterns, and even share with your doctor. That way, you won’t have to wonder, “Is this normal?” You’ll know — and that’s empowering.