5 min read
by Kate Welsh | 01/30/2019
So, you’re in the bathroom, minding your own business, when you look down at your skivvies and see spots. No, literally, you’re *spotting*.
Also called breakthrough bleeding or abnormal uterine bleeding (AUB), spotting is (usually) a small amount of bleeding that occurs between periods. Typically lasting just a couple of days and being significantly lighter (both in flow and color) than your regular period, spotting is still enough to be a *little* annoying, and to possibly freak you out.
The reasons you could be spotting are allllll over the place: mental, physical, not-at-all-a-big-deal emotional stuff, or (more rarely) kinda scary health reasons. If you’re dealing with abnormal vaginal bleeding, it’s a good idea to see your OBGYN, just to be safe.
But to give you some idea of what may be going on, here’s an overview of why your body may be throwin’ ya a curveball:
All sorts of hormonal shifts can cause spotting, and ovulation (aka when your ovaries pop out an egg) may be the culprit in certain cases. If you notice spotting in the middle-ish days of your cycle over a couple of months, an ovum floating down your fallopian tubes could be to blame. This is usually harmless and is caused by typical hormonal spikes. This is just your body’s ~fun~ way of letting you know what’s up with your eggs.
Can stress cause spotting between periods? Extreme stress — both emotional (depression, anxiety) and physical (rapid weight gain or loss, illness) — can mess with your body in a whole bunch of bizarre ways, and causing breakthrough bleeding is just one of them. To get into the nitty-gritty, cortisol (a stress hormone) can wreak havoc on estrogen and progesterone, the hormones that control what your reproductive system is up to. This means that you could experience spotting, but it could also cause your regular period to come earlier or late than it usually does or not at all. Take some deep breaths and make an appointment with a doctor to make sure all is well.
Don’t freak out! But illnesses — everything from STIs like chlamydia, certain cancers, infections, and blood-clotting disorders — can cause spotting. And let's not forget the trio of usual suspects: polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids. These conditions can turn your menstrual cycle into a bit of a wild card. If you deal with PCOS or fibroids, which can throw off your *flow* in all sorts of ways, those conditions may be to blame for some breakthrough bleeding episodes. If you’re worried, talk to your doctor — they’ll be able to help you figure out what’s going on and put together treatment options that will make you feel more in control of your body and menstrual cycle.
When you get pregnant, one of the very first signs *can* be something that looks a lot like breakthrough bleeding but is actually implantation bleeding, or bleeding that occurs when a fertilized egg attaches to a uterus. If you think this may be what’s going on with you, take a pregnancy test or see your doctor.
If you’ve just started to take the birth control pill or the patch or the ring (or really any kind of hormonal birth control), it’s pretty common to deal with some spotting as your body adjusts, especially in the first three months or so. But missing a pill or two (or more), even if you’ve been on birth control for years, can cause a couple of days of irregular vaginal bleeding in the middle of your menstrual cycle. Since birth control pills deliver a steady stream of hormones to your system, a sudden break can make your uterus think it’s time to shed its uterine lining, even if you haven’t gotten to the placebo pills yet. Additionally, changing up your birth control can cause intermenstrual bleeding. Whether you're starting, stopping, or just switching brands, a hormonal change from any of these might throw a mini tantrum in the form of irregular bleeding.
Saved the fun one for last! You might also see a little blood in the middle of your cycle if you’ve had sex that was a little rowdier than normal (or you just weren’t as lubed up as you usually are). Rougher sex can cause tears in the vagina or in the perineum (the area between your vagina and rectum). Usually, these tears heal pretty quickly, but you might want to give your bits a break for a little while to let them heal and avoid any infections.
So, while sometimes these changes in your cycle could just be your body being its wonderfully weird self, other times, they might be waving a little red flag. The best move? Keep an eye on your cycle and have a chat with your doctor if things seem off.
Have you experienced intermenstrual bleeding? bleeding between periods? How did you handle it? Share your stories with us in the comments!
Dr. Brandi Jones, DO is a board certified Obstetrician Gynecologist serving some of the most vulnerable residents of the District of Columbia in a community health center based practice. She is a graduate of Hampton University, and earned her medical degree from Philadelphia College of Osteopathic Medicine. Dr. Jones is an outdoor cycling novice with big goals, and enjoys international travel experiences.
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