Period spotting and when to be worried

‘Spotting’ between periods is often normal, but it’s important to get unusual changes checked. By Liz Connor

If you menstruate, chances are you’ve experienced some light bleeding between your periods at some point or other. This is often referred to as ‘spotting’ – but what does it really mean and should you be concerned about it?

Spotting between periods is something medical experts are frequently asked about. We asked gynaecologists to explain…

WHAT IS SPOTTING?

Spotting, also called ‘intermenstrual bleeding’ (IMB), is basically light vaginal bleeding that happens outside of your regular periods. As gynaecologist Dr Anne Henderson (gynaeexpert.co.uk) explains: “Inter-menstrual bleeding or spotting is a common phenomenon and most women will experience this at some point during their reproductive lives.”

It can appear as spots of blood by itself, of may present within your discharge. This might be reddish, or tinged with shades of brown. “Brown discharge usually occurs after a period, due to blood mixing with the cervical mucus. Usually, it’s nothing to worry about as your vagina is cleaning itself out,” Henderson reassures.

“The presence of blood in vaginal discharge often produces a metallic odour, which is sometimes described as coppery. This can occur around the time of a period or due to bleeding at other times, for example IMB around ovulation.”

WHAT CAUSES SPOTTING?

A number of things can play a part. For instance, if you’re on the pill or regularly miss your pill, you might notice it more. It may also be a sign of an infection.

“The causes will depend on whether a woman is taking a hormonal contraceptive, such as the combined or progesterone-only pill, as hormonal contraceptives are more likely to be associated with IMB due to the effect they have on the endometrium (womb lining),” says Henderson.

“Certain types of infection, particularly STIs and thrush, can also be associated with spotting due to the localised inflammation they cause in the genital tract, including the vagina,” she adds.

IS SPOTTING EVER A CAUSE FOR CONCERN?

In most cases, spotting is harmless and there’s no cause for concern. However, it can also be associated with a range of underlying conditions, some of which can be serious – so it’s always advisable to see a doctor as soon as possible if you experience any new or worsening changes.

Abnormal vaginal bleeding can sometimes be linked to gynaecological cancers. Other possible underlying causes can include uterine fibroids, polyps, endometriosis and polycystic ovary syndrome (PCOS) – although it’s unlikely spotting would be the only symptom. Your doctor can put your mind at rest, and arrange any further tests and investigations if necessary.

“If brown discharge occurs regularly throughout the cycle, it could be a sign of uterine or cervical cancer and should be checked out by a health specialist immediately,” says Henderson.

When spotting is a sign of something more serious, often there will be other symptoms too, such as pain and bloating. “Spotting just before your period can be an indication of endometriosis, but this is usually associated with pelvic pain too. You might have a polyp, a small cell lump, on the womb or on the cervix – both of which are treatable,” says Tania Adib, consultant gynaecologist for Callaly (calla.ly).

Every person has a different ‘normal’, so it’s a good idea to be in tune with your own body and cycle, so you know what’s normal for you and can notice any patterns and changes.