SKIP AHEAD. . .
Spotting vs. Period Differences
The main diff is that spotting is way lighter in volume and appearance than menstrual period bleeding. It can show up randomly or, just as you can have heavy bleeding between periods, spotting can appear at the start, middle, or end of your normal period. If you are spotting between periods or in a particularly bothersome way, call your OB/GYN or midwife to discuss.
Symptoms of period
Periods, or menses as it’s formally known, is the cyclic shedding of the uterine lining and tissue. For many people with uteruses and ovaries, periods start around age 12 or 13 (officially known as menarche) and continues until around age 45-57 (otherwise known as menopause). Periods are triggered by a drop in progesterone and estrogen levels after ovulation, AKA the release of an egg from the ovary. The whole cycle can range from every 21 days to every 35 days in most people (1).
Now let’s get into the specifics: the volume of period blood is around 5 to 12 teaspoons(1)—but those of us who menstruate know that can feel like much more. Periods are often preceded by a healthy dose of pre-menstrual syndrome, or PMS, including fun things like bloating, abdominal cramps, mood swings, acne, breast tenderness, increased appetite, and headaches. This is due to the hormonal flux people experience as their bodies prepare for their period to begin. It is not uncommon for someone to have irregular periods, especially if they have an underlying condition like Polycystic Ovarian Syndrome (PCOS). However, if someone is not on hormonal birth control, they should be having something like a period on a somewhat regular basis. If you don’t or if your period changes suddenly, that warrants a trip to the doctor or midwife.
Symptoms of spotting
Unlike regular periods (vs. irregular) which are literally on a cycle, spotting can be a lot more unpredictable and can vary widely from person to person. In terms of volume, spotting refers to bleeding that is much lighter than a normal period (as in, some “spots” of blood in your underwear), and can be red, dark red, or brownish. Unlike the cramps and mood swings that come with periods, the only sign you’ll have that you’re spotting is the actual spots—there aren’t often any other symptoms.
What causes spotting?
If you are on hormonal birth control, especially a progestin-only method like the IUD or implant, spotting is a very common side effect. Unfortunately, it can be hard to predict when or if spotting will occur. If you’re on hormonal birth control and the spotting is driving you nuts, talk to your doctor or midwife, as there are a few things you can use to try and treat it. Sometimes you can take a few months of estrogen-containing hormonal birth control pills to try and re-regulate bleeding. The estrogen helps to stabilize the lining of your uterus, so taking them reduces spotting. There are even supplements designed for this exact thing, like Flo Living’s Balance kit, which is specifically designed for hormone regulation. If pills aren’t your thing, you can also use a hormonal birth control patch or ring for a few cycles until things even out. It could also go away on its own as your body gets used to the new hormone levels- so if you’d rather wait it out, that’s totally fair! (2)
In the absence of hormonal birth control, spotting can also be a symptom of something more serious, like ectopic pregnancy, polyp, an untreated STI/STD, Pelvic inflammatory Disease (PID), cervicitis, dysplasia, or cervical cancer. The reasons being that inflammation in the uterus or cervix can cause light bleeding that may come out looking like spotting. If your spotting is accompanied by a fever, lower abdominal pain, or unusual vaginal discharge, that could indicate a more serious infection- so give your doctor a call. (2)
Sometimes a UTI can also cause some bleeding from the urethra, which can look identical to vaginal spotting (3). Spotting in early pregnancy is also very common. This is called implantation bleeding, and it occurs after a fertilized egg implants itself into the uterine wall and a hormonal shift occurs. (4) However, if you’re pregnant and you notice spotting, it’s always a good idea to call your OB/GYN or midwife and let them know.
What do I do if I'm spotting?
Spotting may be annoying and bothersome- but it’s usually not harmful. If you notice you have spotting, stock up on pantiliners, wear undies you don’t mind getting stained and start tracking the days you notice it (here’s an app that we love from Flo Living). If it’s happening a lot or if it’s coupled with pregnancy or other symptoms like fever, lower abdominal pain, or unusual discharge, see your doc, midwife, or another care provider right away.
To understand the main differences between spotting and periods, check out this handy reference chart:
Written by: Caitlin O’Connor, Birth control/family planning counselor at UCLA OBGYN
Medically reviewed by: Aisha Williams, RN
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1). Parenthood, Planned. “Is My Menstrual Cycle Normal?: Facts & Information.” Planned Parenthood. Accessed August 06, 2019. https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/how-do-i-know-if-my-menstrual-cycle-normal.
(2) Grace Shih, MD, MAS. “Side Effect Spotlight: What’s up with Spotting?” Bedsider. Accessed August 06, 2019. https://www.bedsider.org/features/113-side-effect-spotlight-what-s-up-with-spotting.
(3) “Urinary Tract Infection | Community | Antibiotic Use | CDC.” Centers for Disease Control and Prevention. Accessed August 06, 2019. https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/uti.html.
(4) Hasan, Reem, Donna D. Baird, Amy H. Herring, Andrew F. Olshan, Michele L. Jonsson Funk, and Katherine E. Hartmann. “Patterns and Predictors of Vaginal Bleeding in the First Trimester of Pregnancy.” Annals of Epidemiology 20, no. 7 (2010): 524-31. DOI:10.1016/j.annepidem.2010.02.006.