Is It Spotting or My Period? Signs, Differences, and Causes

Spotting is light vaginal bleeding that occurs outside of a regular menstrual period. It is different than a normal menstrual period in several ways. Spotting is often harmless but can also be an indication of a problem like a sexually transmitted infection (STI) or uterine fibroids (growths in the uterus).

This article will discuss the symptoms of spotting and menstrual periods and the causes of spotting.

How Do You Know If It’s Spotting or Your Period?

Although spotting and periods both appear as bleeding from the vagina, there are some key differences:

• Spotting is lighter and may not require the use of sanitary protection.
• Periods may also be accompanied by other symptoms that distinguish the two.

Symptoms of Normal Periods

The regular shedding of the lining of the uterus is referred to as menstruation. It may also be called a menstrual period, menstrual cycle, or menses. During this time, blood flows from the vagina. In people with a uterus and ovaries, it usually occurs monthly from puberty until menopause (marking the end of menstruation, when periods have stopped for 12 straight months). Menstruation normally stops during pregnancy.

In addition to vaginal bleeding, many people experience other symptoms while menstruating. These include:

• Cramping in the lower abdomen
• Cramping in the lower back
• Moodiness
• Cravings
• Difficulty with sleep
• Bloating
• Tender breasts
• Acne

Conditions Causing Symptoms of Spotting

Any bleeding or spotting that occurs outside the usual time of menstruation is considered abnormal uterine or vaginal bleeding. But this doesn't always mean it is something to worry about.

Spotting is light bleeding that comes from the vagina. It may appear as a few spots of blood on your underwear. This will not require the use of sanitary protection like a pad, panty liner, or tampon.

Spotting or abnormal bleeding can be due to several causes, including polycystic ovary syndrome (PCOS), pregnancy, ectopic pregnancy, ovulation, birth control, STIs, cancer, fibroids, and perimenopause.

What Causes Spotting

Spotting can be normal and nothing to worry about, or it can be an indication of a problem that warrants attention by a healthcare professional.

Pregnancy

During the first trimester (first 12 weeks of pregnancy), 15–25 out of every 100 pregnancies will experience bleeding. One to two weeks after a fertilized egg implants into the lining of the uterus, some spotting or light bleeding may occur.

During pregnancy, it is also possible to experience spotting or light bleeding following sexual intercourse, a Pap test (a swab of the cervix to check for abnormal cells), or a pelvic exam (internal and external examination of the organs in the pelvis).

Ectopic Pregnancy

An ectopic pregnancy happens when a fertilized egg grows outside the uterus, most commonly in the fallopian tube. This is a nonviable pregnancy that must be treated to prevent potentially severe (even fatal) complications.

An ectopic pregnancy may cause pregnancy symptoms like a missed period or tender breasts. It may also cause:

• Abnormal bleeding from the vagina
• Mild cramping to one side of the pelvis
• Mild abdominal pain
• Lower back pain

Polycystic Ovary Syndrome

Polycystic ovary syndrome is a hormonal disorder that can cause irregular menstrual periods and problems with fertility. People with PCOS may experience abnormal vaginal bleeding like spotting due to a lack of ovulation.

Birth Control Pills

Birth control pills and other forms of hormonal contraception can cause side effects. Among these side effects is spotting, also referred to as breakthrough bleeding. This most commonly happens in the first few months of starting a new form of hormonal birth control. Spotting may stop after this time.

Implantation Bleeding

Following fertilization, an embryo attaches to the wall of the uterus. During this time, some blood vessels can break down, and this can cause spotting.

This is known as implantation bleeding. The spotting may be brownish in color and is not heavy. It may not occur in every pregnancy.

Uterine Fibroids or Polyps

Uterine fibroids are growths of the uterus. They are not cancerous and may not cause symptoms.

If symptoms do occur, they may include:

• Abnormal vaginal bleeding like spotting
• Lower back pain that persists
• Pelvic pain
• Pain during sex
• Urinary issues

Uterine polyps are growths in the lining of the uterus that are usually noncancerous (although they can also be precancerous or cancerous). They may also cause spotting.

Ovulation Bleeding

Spotting can occur any time during the menstrual cycle. Ovulation marks the middle of the cycle, when the ovary releases an egg. During ovulation, some light spotting may occur. This is not a cause for concern.

Breastfeeding

People who exclusively breastfeed a child may not have a period for months or even a year after childbirth. If a person partially breastfeeds, their periods may return as soon as three weeks following birth.

When breastfeeding time is reduced and periods begin to return, this may start as light spotting.

Injuries

Injuries in the genital area can cause spotting. Injuries or trauma to the genital area include:

• Cuts
• Bruises
• Lacerations

Straddle injuries can also cause spotting. These injuries occur when a person falls onto an object, like a fence, bike, or playground equipment, and strikes the object with their groin area.

Miscarriage

The most common indication of a miscarriage (loss of a pregnancy in the first 20 weeks of gestation) is bleeding from the vagina. Bleeding can range from a brown discharge and light spotting to heavy bleeding and clots. This can come and go.

Perimenopause

Perimenopause can occur from ages 45 to 55. During this time, the ovaries become smaller and make less estrogen. It is normal to have spotting during this time.

Cancer

Roughly 90% of people who have endometrial cancer (cancer of the uterine lining) have some form of abnormal vaginal bleeding. This can include spotting, changes to periods, and bleeding after menopause.

STIs

Not all STIs have symptoms, but STIs like chlamydia can cause bleeding between periods.

Other symptoms that may accompany spotting with STIs include:

• Unusual genital discharge
• Pain during sex
• Pain in the lower abdomen
• Bumps and sore on the genitals
• Pain with urination
  

Summary

Spotting is light bleeding that may appear as spots of blood in the underwear. Unlike menstrual bleeding, it typically does not require the use of a pad or tampon. Spotting can have many causes, including ovulation, early pregnancy, infections, or injuries to the genital area. If you are concerned about spotting, speak with your doctor.

A Word From Verywell

Knowing what is normal for your menstrual flow allows you to identify when you are having abnormal vaginal bleeding. Whenever you have a concerning symptom, call your healthcare professional for advice. They have heard such questions often and will be able to ensure you get appropriate diagnosis and treatment.