Spotting Before Your Period: Causes, Symptoms, and When to See a Doctor

Most of us have felt that moment of panic: spotting a drop of blood on light-colored underwear or on toilet paper before our period starts. It’s not enough to reach for a tampon, but just enough to leave you wondering what’s going on.

Before you start panicking, spotting before your period is totally normal. A study found that nearly 42% of women experience spotting. However, in some cases, it can also be a sign of an underlying health condition. 

Let’s lift the lid on what this in-between-period spotting means, why it happens, and when you should be concerned. 

What is spotting before a period?

Spotting is light vaginal bleeding that happens in between your regular periods. The blood during spotting is typically lighter in color when compared to the blood during your period. 

It’s completely normal for spotting to appear pinkish or brownish. Spotting usually isn’t heavy enough to require using menstrual products such as pads or tampons (although you may use a panty liner if you don’t want to go through the hassle of washing the blood off your underwear). 

So, if you notice a few drops of blood in your underwear or toilet paper a couple of days before your period is due to start, you’re most likely spotting. Spotting may also occur a few days after your period ends. In most cases, this is just old blood that has stayed back just a bit longer in your uterus.

Period blood, on the other hand, is heavier and darker in color, with the bleeding lasting for a few days. Period blood is usually substantial enough to also require using tampons or pads.

Common Causes of Spotting Before a Period

Your period is very complicated, but, simply put, it's nature's way of telling you you're not pregnant. When your egg is not fertilized, your body naturally sheds the uterine lining that holds the egg. When the uterine lining starts to break down, it can bleed a little before your actual period starts. This means brown discharge before your period is totally normal, especially a few days before your uterine lining completely sloughs off. 

This is why some women actually notice spotting 2 to 3 days before their period every month. This also explains why spotting is lighter in color and not as heavy as your period.

However, shedding of your uterine lining is only one cause for spotting. We’ll look at the other possible causes of spotting below. 

Hormonal birth control

Hormonal contraceptives, such as pills, patches, injections, rings, and intrauterine devices (IUDs), can cause spotting, especially during the first 3-6 months. This is thought to be because of the way the progestin hormone from the birth control thins out your uterine lining. 

In addition to preventing pregnancy by not letting a fertilized egg implant properly, this thinning of your uterine lining can cause some spotting initially till your body gets used to the hormonal changes. 

If you're on the pill, skipping a single dose can also throw your hormones off completely. Even taking them at different times every day can lead to light spotting. However, it can usually be resolved quickly by just taking the pill. 

Sometimes, even changing your type of hormonal birth control can alter your progesterone levels enough to cause spotting. All it takes is allowing your system to get used to the hormone levels of your new contraception. Additionally, if you currently have an IUD (either hormonal or non-hormonal), spotting before your period is totally normal.

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Hormonal fluctuations

PCOS: Certain conditions, such as Polycystic Ovary Syndrome (PCOS), can cause spotting before your period. PCOS throws your hormones out of balance due to an overproduction of testosterone, the male hormone, by your ovaries. This upsets the delicate balance of your reproductive hormones, causing missed periods, heavy bleeding, and spotting.

Perimenopause: During perimenopause, your body prepares itself to step into menopause. Perimenopause typically starts in your mid to late 40s and can last anywhere between four and eight years. 

During this transition period, the amount of estrogen produced by your ovaries starts decreasing, which upsets the balance of the other menstrual hormone, progesterone. This fluctuation can cause spotting. So, if you’re in your 40s and experience spotting along with vaginal dryness, hot flashes, or night sweats, it might be perimenopause. 

Thyroid issues: Did you know that the thyroid hormones play a role in your menstrual cycles? When the thyroid gland produces more (or less) thyroid hormones than needed, it can cause irregular periods and even spotting in between.

Ovulation spotting

Although only 5% of menstruating people experience it, spotting might happen when you’re ovulating. Ovulation is when your ovaries release an egg, hoping to be fertilized. It typically occurs around the middle point of your menstrual cycle.

Though more research is needed, the cause of ovulation spotting is associated with a drop in estrogen levels, which increases progesterone levels, causing an imbalance, or a spike in the luteinizing hormone (LH), a hormone which triggers ovulation. Spotting during this period will typically be light pink or red. 

Implantation bleeding

Implantation is the process of a fertilized egg travelling to your uterus and attaching itself to your uterine wall. This is when a pregnancy begins. Implantation typically happens around a week after ovulation and a few days before you’re due for your next period. 

While it doesn’t happen to everyone, some people experience spotting during this period (along with some cramping). It’s thought that the implantation of the fertilized egg into the uterine wall breaks down some of the blood vessels there, causing light bleeding. The discharge during this time is unusual in color, ranging from light pink to very dark brown to even black in some cases. 

Infections and STIs

If you tend to spot after intercourse, you could be suffering from vaginal irritation. This can be anything from a yeast infection to a sexually transmitted infection like chlamydia or gonorrhea. An infection can cause inflammation of cervical tissue, which can result in painful urination, discharge, painful intercourse, and bleeding or spotting after sex.

Urinary tract infections (UTIs) can also cause bleeding and pain, especially when you urinate. Bottom line, if you see spotting combined with pain, get it checked immediately. 

Cervical or uterine polyps or fibroids

Fibroids and polyps are non-cancerous growths in your uterus or cervix. They often don’t have any symptoms and aren’t typically harmful. In fact, you probably won’t even know they’re there! They can, however, cause spotting in between periods.

Medications

There are some types of medications that can cause light vaginal bleeding between your periods. The usual suspects include some antidepressants, thyroid medication, blood thinners, hormone medications, and one-time oral contraceptive pills such as Plan B. 

Stress

Stress is notorious for causing all sorts of emotional and physical changes in our bodies. These changes also include disrupting your estrogen levels (due to an increase in cortisol, the stress hormone). This disruption can lead to light vaginal bleeding outside of your period. 

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Spotting vs. Your Period: How to Tell the Difference

Here are some ways to tell the two apart. 

When is Spotting Not Normal?

While spotting doesn’t always signal an underlying issue, here are some signs that it may not be normal:

• You’re experiencing it frequently, and it continues for more than 2-3 days

• There’s persistent bleeding after sex 

• Your spotting isn’t followed by a period

• It’s accompanied by pain, especially in your lower abdomen or pelvic area

• You experience bleeding during urination

• There’s abnormal discharge with a fishy odor

• It’s accompanied by vaginal itching

• It’s happening after menopause

• You’re bleeding consistently or heavily during your pregnancy

• If it’s accompanied by dizziness, fatigue, sudden weight changes, or a fever

These signs indicate that you need medical care.

Should I Talk to a Doctor About Spotting?

Spotting before your period doesn’t always mean that the alarm bells are ringing. Sometimes, it’s completely normal. But you should consult a doctor right away if you notice any abnormal spotting (see above). 

Speak with your doctor as well if you’re anxious, unsure, or if spotting is unusual for you.

How to Track and Manage Spotting

Though most causes of spotting are normal or easily treated, keeping a diary of irregular spotting is the perfect place to begin investigating more serious health problems. You can use a period tracking app like Flo to stay on top of your cycle. This will help you know when to anticipate your period, so that you can identify and note down any in-between bleeding. 

You can also use symptom journaling to track your spotting. Note down whether you’re experiencing any unusual discharge or pain, and also when the spotting occurs. i.e. is it after sex? When you’re peeing? During your ovulation dates?

If you've never experienced spotting before and it suddenly happens, or if it starts more than four days before your period, it's worth consulting your gynecologist. When doing so, it would be immensely helpful to give your doctor the exact dates of your spotting versus the dates of your regular periods. Also mention if you’re on any type of birth control.

Some underlying issues that can throw your cycle off can include thyroid disorders, cervical polyps (though almost always benign, these growths on the cervix should always be examined by your OBGYN), and even diabetes or obesity. Perhaps in the rarest of cases, spotting before your period can be a symptom of cervical cancer. Again, this spotting is so rare, but if it does cause bleeding, it typically happens after sex, not before your period.

In any case, consulting a doctor will not only help detect more serious health problems, it can offer peace of mind if nothing is actually going on. Being a woman comes with some complicated menstrual cycles, but the good news is there's always a solution.

Curious about what’s normal throughout your cycle? Explore more period health insights and expert-backed answers on the LOLA blog.

FAQs

Is spotting before a period normal?

Yes, spotting before a period is normal. This blood is typically lighter in color than your period blood, and you’ll probably see no more than a few drops at most. However, if your spotting is heavy and persistent or accompanied by pain, vaginal itching, unusual discharge, a bad odor, or symptoms like fever, nausea, and dizziness, it may be a sign of some other underlying medical issue and needs medical intervention. 

What color is spotting before a period?

Spotting before your period is typically light pink, brown, or reddish in color. Your period blood, on the other hand, is bright or dark red. 

When should I be concerned about spotting?

If your spotting continues for a long time, is heavy, is happening after your menopause, or is accompanied by other symptoms such as pain, fever, dizziness, vaginal itching, abnormal discharge, or a fishy odor, you should consult your doctor immediately.

Can spotting mean pregnancy?

Yes, spotting can sometimes be an early sign of pregnancy. If you had unprotected sex, are of reproductive age, and have other symptoms like morning sickness, you can take an at-home pregnancy test to confirm. 

Keep in mind, though, that to accurately determine whether you’re pregnant or not, it’s best to wait till a week after you miss your period before you take the test, as testing too soon can result in false negatives.

Can stress or exercise cause spotting?

Yes, stress and exercise (particularly intense physical activity) can cause hormonal fluctuations, leading to spotting.