Causes of Spotting and Bleeding After Periods

What’s normal and when to worry about blood after menstruation

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Spotting after a period ends but before the next one begins is common and can occur because of the drop in estrogen that occurs before ovulation. Unlike heavy menstrual flow, spotting involves only small amounts of pink or dark brown blood—not enough that you'll need a pad or tampon.

You may notice spotting every month or only in between some periods. Some don't experience it at all.

While spotting after a period can be perfectly normal, bright red and/or more significant bleeding between periods could be a sign of a more serious health problem like a miscarriage or a hormonal condition. Bleeding after a period along with vaginal discharge can be a sign of an infection.

This article goes over the most common reasons for spotting and other bleeding between periods. You'll also learn when to call your healthcare provider.

What Causes Spotting and Bleeding After a Period?

Hormonal fluctuations are one of the most common reasons for bleeding between periods. This can be anticipated and unconcerning, such as with use of birth control or in perimenopause. Or it may be due to a hormonal condition like thyroid disease the requires medical attention.

Spotting and heavier bleeding between periods also have a variety of other potential causes unrelated to hormones, including inflammatory conditions, cancerous and noncanerous growths, and more.

Causes of irregular menstrual bleeding

Verywell / Jessica Olah

Birth Control

Bleeding between periods can happen because of your birth control method and how you use it. The reason? Shifts in your hormones, particularly estrogen.

  • Oral contraceptives: Starting, stopping, or missing birth control pills can cause spotting, or what's known as breakthrough bleeding. Low-dose or extended-cycle pills are more likely to cause this.
  • Other hormonal birth control methods: Irregular vaginal bleeding can happen if you're using a contraceptive patch, implant, or injection, especially if you miss a dose.
  • Intrauterine devices (IUDs): Intrauterine devices may cause occasional spotting, especially right after you get it inserted. Some people have occasional spotting for the first few months after an IUD has been put in as their body is adjusting.

Some people are more likely to get spotting from birth control than others, such as people who smoke or tend to forget to take their birth control pill on schedule.

Pregnancy

Menstruation temporarily stops during pregnancy. Spotting or more substantial bleeding can happen after your last period, sometimes before you even know you are pregnant and not to expect your next one.

There are a few different causes, some of which are serious:

  • Implantation bleeding: Spotting can happen when the fertilized egg implants in the uterus and begins to grow.
  • Miscarriage: Bleeding that happens early in pregnancy—especially if it's heavy—may mean that you've had a miscarriage.
  • Ectopic pregnancy: This occurs when a fertilized egg implants outside of the uterus. One of the signs is vaginal bleeding. An ectopic pregnancy is a medical emergency.

Hormonal Conditions

Irregular periods or spotting are common in perimenopause, the transition into menopause. Your body's sex hormones are fluctuating and your usual menstrual cycle is no longer as predictable as it once was.

That is normal and expected. But, there are hormonal medical conditions that can cause spotting and heavier bleeding between periods, too. These require treatment:

  • Thyroid disease: Low or high thyroid levels can affect other hormone levels and lead to problems with your menstrual cycle, including irregular bleeding or even missing your period altogether.
  • Polycystic ovary syndrome (PCOS): This hormone imbalance affects ovulation and commonly causes irregular menstrual cycles. The hormonal imbalances caused by PCOS can lead to bleeding between periods, which can range from light spotting to heavy flow.

Common Infections

Infections are another common cause of bleeding between periods. The tissues in your reproductive system are very sensitive, so inflammation there can easily lead to bleeding. This can be more likely after having vaginal sex.

Spotting can be a sign of:

  • Vaginal, cervical, and uterine infections and inflammatory conditions
  • Sexually transmitted infections (e.g. chlamydia, gonorrhea, and genital warts)
  • Pelvic inflammatory disease (PID)

An infection may cause vaginal discharge along with spotting. Depending on what is causing the infection, the vaginal discharge can be white, yellow, or green.

Other Causes

There are also some other potential causes of spotting and other bleeding between periods:

Can Stress Cause Spotting Between Periods?

Stress can affect your menstrual cycle. Sometimes, being under a lot of stress can make your period late or early. You might even miss a period. It's possible that you could have bleeding between periods that's related to stress, but research on this is lacking.

Is It Spotting?

A healthcare provider will only consider vaginal bleeding "spotting" if you see it before or after your period and it does not require you to use a pad or tampon. Heavy bleeding that lasts a few days or even as long as your typical period is a greater cause for concern.

A slight tinge of blood on toilet paper or a little bloody stain in your underwear is probably spotting. Unlike period bleeding, which is bright red to slightly dark red, spotting can be lighter (pinker) or darker (brown). Older blood is usually brown or even close to black.

Normal Menstrual Bleeding

Normal menstrual bleeding lasts for about five to seven days. The average menstrual cycle has about 28 days between periods, but it's normal to have a cycle that lasts anywhere from 21 to 35 days.

If the egg that's released during ovulation is not fertilized, your period will start about two weeks after you ovulate. During your period, the uterine lining sheds because it's not needed to support a pregnancy.

People who menstruate get to know their cycles with time, both in terms of how long the bleeding lasts and how much bleeding is typical. Although it may seem like you are losing a lot of blood, it usually only adds up to around 2 to 3 tablespoons per period.

While your period is the only time during your cycle when you should expect bleeding, a little spotting between periods can happen and can be normal. For example, some people have spotting during ovulation.

However, if your cycles are irregular and you're not sure if the spotting is related to ovulation, talk to your provider. They can help you figure out why you're bleeding between periods and whether it's a cause for concern.

What Is Ovulation Bleeding?

This type of bleeding occurs just before or after your period when your estrogen levels dip. It's not technically spotting; rather, it’s considered part of your period. Ovulation bleeding may happen at this point in the menstrual cycle because estrogen and progesterone levels are fluctuating as the ovary releases an egg.

When to Worry About Bleeding After Your Period

Occasional light spotting between periods may not be a reason to worry. However, frequent, unexplained vaginal bleeding between periods is something to talk to your provider about, especially if:

  • You have not gone through puberty yet
  • You could be pregnant
  • You're past menopause
  • The bleeding is more like or heavier than a regular period rather than just a drop or two of blood
  • The bleeding comes with other symptoms like a bad-smelling discharge and intense cramps

It can be useful to keep track of your menstrual cycle with a calendar or app. This information can help you and your healthcare provider figure out whether any spotting or bleeding outside your cycle is a concern.

If you need to use feminine products, keep track of how many you go through in a day. This can give your provider a sense of how much you're actually bleeding.

When Is Bleeding Between Periods an Emergency?

If you are bleeding between periods and also have a fever, dizziness, bruising, or pain, seek emergency medical care—especially if the bleeding is very heavy and you can't stop it.

Summary

Many people experience spotting or bleeding between periods. Most of the time, a little bleeding when you're not on your period is not a reason to worry.

However, if you're also having other symptoms like pain, spotting between periods can be a sign that something is wrong.

If you have any vaginal bleeding, light or heavy, tell your provider. That's the only way to find out for sure what is causing it and make sure you get the right treatment.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.