What Is Spotting and When Is It Normal?

    Updated 23 April 2020 |
    Published 29 August 2018
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    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK
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    The term “spotting” usually refers to light bleeding that occurs outside of your normal period. You might have spotting a week before your period, after sex, or even during ovulation. But how do you distinguish between spotting before your period and the menstrual bleeding itself? What are the most common spotting causes? Let’s get into more detail.

    What is spotting?

    Many people find their period inconvenient, or worse, and look forward to the day of the month when they stop bleeding. But have you ever noticed a little bit of blood when you weren’t expecting it?

    Spotting (minor vaginal bleeding between periods) is a common occurrence and usually nothing to worry about. In this article, we’ll explain more about why it happens and when you might need to visit a health care provider. Most cases are harmless and require no medical intervention, but some cases will necessitate expert investigation and possible treatment.

    Join Flo as we cover the most common reasons for spotting between periods.

    Spotting vs. period: differences

    If you’re experiencing something that looks like spotting in your vaginal discharge but are expecting your period, how can you tell the difference? Here are some distinctions between spotting and menstrual bleeding.

    The menstrual period is the typical monthly bleeding process. Your uterine lining gets thicker over the course of your cycle and then sheds during your period. It may be difficult to distinguish between spotting before your period and the menstrual flow itself. 

    The color of your menstrual blood might be anywhere from red to dark brown. It may look almost inky black toward the end of your period. 

    There are several differences between period bleeding and spotting. Spotting is lighter bleeding than the heavier flow of menstruation. From a medical standpoint, spotting technically has one or more days without bleeding before or after menstruation. It shouldn’t be accompanied by heavy cramps or clots. The color is light brown or pink. 

    Spotting can occur at any time of your cycle and is often linked to ovulation, but sometimes it’s a signal of other changes in your body. 

    Spotting vs. period vs. bleeding: Know the difference

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    Is spotting before your period normal?

    Although spotting is a very common occurrence, it can still be worrying for many people. Particularly if you’re used to having a regular period, it can be a bit of a shock to find a small amount of blood in your underwear.

    But before you start to worry, just remember that most cases of spotting are completely normal, harmless, and won’t require any further investigations or treatment. If you do need to visit a health care provider, seeking expert advice as soon as possible will make sure you get to the bottom of the issue and receive treatment if necessary.

    Spotting a week before your period: should you be worried?

    If it’s a week before your period and you’ve just noticed a little bit of blood, don’t panic!

    Later on, we’ll go over some of the most common causes of spotting. But first, here’s a quick list of symptoms to watch out for. If you’re experiencing spotting along with any of these, make sure to make an appointment with your health care provider as soon as possible.

    • Pain in your lower abdomen
    • Fever
    • Worsening or more frequent symptoms
    • Spotting or any other vaginal bleeding after menopause

    If you have any of these symptoms, then you should seek professional advice as soon as possible. Now let’s get into some of the reasons why you might be experiencing spotting.

    Possible causes of spotting before periods

    Spotting has a number of possible causes. Here are some of the most common:

    • Hormone-based birth control — If you’re using a hormone-based contraceptive (whether the pill, patch, injection, or intrauterine device), you may experience some spotting during the first three months of using it. Health professionals refer to this as “breakthrough bleeding,” and it may be linked to changes in the lining of the uterus triggered by the hormones in your contraception. Barrier methods of contraception like condoms are not associated with spotting.
    • Sexually transmitted infections (STIs) like chlamydia — STIs are on the rise in many parts of the world, and many spread quickly because they frequently don’t cause any symptoms. In addition to spotting, STIs can cause abnormal vaginal discharge, abdominal pain with fever, and pain when urinating or having sex. If you have any reason to believe that you might have an STI, it’s important for you and your partner to get tested immediately.
    • Uterine fibroids or polyps — Polyps are localized extensive growths of the lining of the uterus. Uterine fibroids are benign (non-cancerous) tumors that grow in the muscle of the uterus. Both polyps and fibroids can be associated with heavy periods, spotting, and difficulty getting pregnant. Large fibroids can be associated with pain, constipation, and difficulty urinating.
    • Polycystic ovary syndrome (PCOS) — People with PCOS may have increased levels of male sex hormones (androgens), which can lead to irregular periods and spotting.
    • Cancer of the reproductive system — This includes uterine and cervical cancer, among others. These cancers are much more common if you have been through menopause, but can also occur if you’re younger. If you’re over 40 and have noticed spotting between periods, it’s best to visit your health care provider so they can investigate appropriately.
    • Perimenopause — As you approach menopause, the hormone levels in your body change, and in response to this, the lining of your uterus becomes thicker. This can make it more difficult to anticipate the timing of your period. It can also lead to spotting and other symptoms.

    Most causes of spotting are nothing to worry about and require no medical intervention. In rare cases, spotting could be the result of a more serious underlying condition that needs attention and/or treatment.

    If you’re concerned about any of the conditions above or you’re worried about spotting for any other reason, don’t hesitate to make an appointment with your health care provider.

    Spotting on the birth control pill: should you be worried?

    Having breakthrough bleeding (spotting between periods) is quite common if you’re taking birth control pills.

    The reasons for spotting while on birth control vary from person to person and also depend on the type of pills you use.

    If you have just started taking the pill, you may bleed between periods as your body adjusts to the changing hormone levels. Spotting between periods should stop after a few months and is not dangerous.

    Skipping a pill or two can also lead to spotting. This is normal and nothing to worry about. Remember that it’s important to take oral contraceptives consistently and correctly in order for them to be effective at preventing pregnancy.

    Spotting during ovulation

    Although rare, some people see cervical fluid that is streaked with blood or has a pink tinge during ovulation. It is generally considered normal.

    Hormonal changes during this time are a possible explanation for such discharge. Before ovulation, your level of estrogen starts to decrease, which can cause spotting. Use Flo to track all of the changes in your vaginal discharge and get helpful tips.

    Spotting after sex: what does it indicate?

    Some people experience spotting during sex or bleeding after sexual intercourse, known as postcoital bleeding.

    Some possible causes for bleeding after sex are:

    • Friction and damage to the vaginal mucosa and cervix during sex, caused by dryness and lack of lubrication
    • Vaginal and cervical inflammation
    • Sexually transmitted infections
    • Endometriosis

    Normally, this type of discharge is a one-off occurrence, doesn’t pose a health threat, and is not a reason for concern.

    However, if bleeding after sex occurs regularly and/or is accompanied by pain or other symptoms, you should contact your health care provider to find out the cause.

    6 potential reasons you’re bleeding after sex — and what to do

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    “Abnormal Menstruation (Periods): Types, Causes & Treatment.” Cleveland Clinic, 25 Aug. 2019, my.clevelandclinic.org/health/diseases/14633-abnormal-menstruation-periods. Women’s Health Team. “Bleeding Between Periods? How to Tell If It’s a Problem.” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 12 Apr. 2018, health.clevelandclinic.org/when-should-you-worry-about-spotting-between-periods/. Burnett, Tatnai. “Extended-Cycle Birth Control Pills: Is Breakthrough Bleeding More Common?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Feb. 2020, www.mayoclinic.org/healthy-lifestyle/birth-control/expert-answers/seasonale-side-effects/faq-20058109. Sweet, Mary Gayle, et al. “Evaluation and Management of Abnormal Uterine Bleeding in Premenopausal Women.” American Family Physician, 1 Jan. 2012, www.aafp.org/afp/2012/0101/p35.html. “What Causes Bleeding between Periods?” NHS Choices, NHS, 5 Nov. 2019, www.nhs.uk/common-health-questions/womens-health/what-causes-bleeding-between-periods/. Mayo Clinic Staff. “Vaginal Bleeding.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Apr. 2019, www.mayoclinic.org/symptoms/vaginal-bleeding/basics/definition/sym-20050756. “Vaginal Bleeding between Periods.” UF Health, University of Florida Health, 28 Mar. 2019, ufhealth.org/vaginal-bleeding-between-periods.

    History of updates

    Current version (23 April 2020)

    Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK

    Published (29 August 2018)

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