5 min read
by Team Thinx | 04/02/2023
For many, the week after your period is a magical time. You can confidently step away from the heating pad, place your secret stash of mini chocolate bars back in the pantry (if you must), and finally put your period undies away for a few weeks.
All is right in the world… until you look down at your pristine white undies and find them in not-so-pristine condition. Hold the phone — why am I spotting one week after my period?
Don’t panic! Bleeding between menstrual cycles is pretty common and may be due to a handful of different causes. From changes in birth control, hormonal changes, to post-pap smear bleeding, we’ll dive into all the possible reasons you could be breakthrough bleeding or spotting between periods below.
Birth control options come in all shapes and sizes (and, if you use oral contraceptives, colors!). Some prefer over-the-counter, non-hormonal options, like condoms and diaphragms. Others use hormonal contraceptives such as:
Daily birth control pill (oral contraceptives)
The birth control implant (placed under the skin of your arm)
An intrauterine device (IUD)
The birth control shot, which you receive every three months from a doctor
The monthly birth control ring
The skin patch
Hormonal birth control methods work by using synthetic hormones to stop your body from ovulating each month. If you take a form of hormonal birth control, it’s not uncommon to notice spotting between periods.
However, not all birth controls are created equal when it comes to spotting. The most likely ones to cause intermenstrual bleeding are:
Low-dose birth control pills
These forms of birth control contain 30 to 35 micrograms of estrogen—significantly less than other kinds of birth control containing 50 micrograms. (Other types of birth control, like the progestin-only “mini pill,” contain no estrogen).
Many people who take low-dose birth control notice fewer unpleasant side effects overall (ahem — we’re looking at you, sore breasts and random unannounced headaches). However, with low-dose birth control, you may also note spotting or bleeding between periods that usually subsides after the first few months.
Some individuals may be more prone to spotting than others, including people who:
Don’t take their birth control regularly
Use emergency contraception in addition to taking birth control
Take a continuous dose of their pills or vaginal ring to avoid having a period
Birth control isn’t the only reason you might notice spotting in your underwear. Some medical conditions can have an impact on whether you have spotting between periods, especially if they affect your hormones.
If you have one of the following conditions, it might explain any (seemingly inexplicable) spotting:
Thyroid disease – Located at the base of your neck, the thyroid gland handles many essential functions, like burning calories and controlling your menstrual cycle. If your body is making too much of the thyroid hormone (hyperthyroidism) or too little (hypothyroidism), it may increase your chances of irregular uterine bleeding.
Polycystic Ovarian Syndrome (PCOS) – PCOS occurs when there’s a reproductive hormonal imbalance in your body. This can affect your ovaries and inhibit their ability to release an egg when it’s time for ovulation. Because of this, some people experience irregular periods, which you might notice as spotting.
Perimenopause – The major (and sometimes challenging) time in a person’s life that leads up to menopause is also known as perimenopause. During this time, your body continues to make estrogen while there’s slow and low progesterone production. Because of the ever-changing levels of hormones, you may notice more severe PMS-like symptoms than usual, like mood swings, hot flashes, and irregular periods.
Have you noticed any abnormal discharge along with your spotting? Do you notice dark brown discharge instead of period blood? If so, the intermenstrual bleeding may be because of an underlying infection. Of course, that’s not the only symptom associated with infections. Below, we’ve included a list of infections (and their symptoms) that could be the cause of your spotting.
Vaginitis is an inflammation of the vagina, usually caused by an imbalance of bacteria or infection in the vagina. In addition to spotting between periods, you may also notice:
Discomfort when you pee
Changes in vaginal discharge, including its color, amount, or smell
There are three main types of vaginitis, including:
Bacterial vaginosis – This type of vaginitis is usually accompanied by an unpleasant fishy odor, especially after sex.
Yeast infection – In addition to itchiness around the vagina, a yeast infection often causes a thick discharge that sometimes has a cottage cheese-like appearance.
Trichomoniasis – Trichomoniasis is a sexually transmitted infection (STI) often associated with many of the typical vaginitis symptoms.
Trichomoniasis isn’t the only STI that can cause spotting between periods. The following STIs can also cause occasional bleeding:
All three share similar symptoms, like:
Increased vaginal discharge
Vaginal irritation (which can cause pain during sexual intercourse)
PID usually occurs when sexually transmitted bacteria have traveled upward to your reproductive organs. This can cause pain in your lower abdomen and pelvis. While some people who have PID don’t notice any symptoms, others observe a combination of the following:
A change in vaginal discharge that may have an odor
Unusual bleeding that occurs after sex or between periods
Pain during sex
If you believe you have an infection, schedule an appointment with your OBGYN to determine the cause of the bleeding and other symptoms. If you do have an infection, they’ll create a treatment plan to ease your symptoms and get rid of the infection.
Birth control, hormonal disorders, and infections aren’t the only reasons you could be experiencing unexplained spotting in the middle of your monthly cycle. There are other potential medical conditions and explanations to consider as well, including:
Endometriosis – Endometriosis occurs when the tissue that normally lines the uterus grows outside of it. Sometimes that tissue forms cysts and scar tissue on your reproductive organs, which can cause severe pain and irregular bleeding between periods.
Uterine fibroids – Also known as leiomyomas, uterine fibroids are noncancerous growths that form on the uterus. They’re more likely to crop up during your reproductive years. While some people don’t have symptoms, others notice heavy bleeding during their periods, abnormal uterine bleeding between periods, and back and pelvic pain.
Medications – There are a handful of medications that can cause spotting between menstrual cycles, like anticoagulants, corticosteroids, antidepressants, and antipsychotics.
Gynecological procedures – If you happen to go to the gynecologist for your annual checkup and they tell you it’s time for a pap smear, you might be surprised to find some light spotting after the procedure. It’s completely normal and goes away on its own in a day or two.
If you’re not on your period and you’re experiencing bleeding, you may begin to wonder if you should feel concerned. While it’s often natural and nothing to worry about, it may be time to schedule an appointment with your gynecologist to get confirmation.
In the meantime, you can keep a running record of your symptoms to share with your physician at the visit. If you think of any questions to ask, you can write them down or keep them in the notes section of your phone and bring them with you as well.
During the appointment, your healthcare provider will ask you a series of questions and ask you to describe your symptoms. Then, they’ll likely perform a physical exam and pelvic exam.
Depending on their findings, they may also order one or more of the following tests to narrow down the cause of the bleeding:
Thyroid functioning tests
Complete blood count
Magnetic resonance imaging (MRI)
After your physician diagnoses the reason behind the spotting, they’ll devise a treatment plan (if necessary) to decrease the bleeding and other symptoms. Depending on your diagnosis, they may recommend a variety of treatment options, such as:
A change in birth control methods
Medication that stops the flow of your period and helps to shrink uterine fibroids
Antibiotics, if the bleeding is caused by an infection
Non-steroidal anti-inflammatory drugs (NSAIDs), (aka ibuprofen) to control occasional heavy bleeding
Whether you’re on your period or you’re experiencing spotting between menstrual cycles, vaginal bleeding is a part of life. But if you notice spotting or abnormal bleeding during a time you normally wouldn’t, take care of yourself by contacting your physician to get to the root of the problem.
When it’s time for your period to make its next grand entrance, give yourself grace (and free rein) to enjoy the little things in life. Take out that bag of chocolates you hid from your roommate and grab your comfiest pair of Thinx underwear to make your bleeding days that much cozier.
Thinx look and feel like normal undies, but they offer built-in period protection so you can conquer each day of your period — whether “conquering” means signing off on a big work project or vanquishing that last episode of your latest favorite streaming series.
From Boyshort to the classic Hiphugger, browse our collection to find the perfect fit for you and your flow.
At Thinx, we strive to provide our readers with the most up-to-date, objective, and research-based information. Our content is crafted by experienced contributors who ground their work in research and data. Articles contain trusted third-party sources that are either directly linked within the text or listed at the bottom to lead readers to the original source.
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Planned Parenthood. Birth Control Pill. https://www.plannedparenthood.org/learn/birth-control/birth-control-pill
Planned Parenthood. What Are the Disadvantages of the Pill? https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/what-are-the-disadvantages-of-the-pill
ACOG. What You Should Know About Breakthrough Bleeding With Birth Control. https://www.acog.org/womens-health/experts-
NIH. Thyroid Dysfunction in Patients with Abnormal Uterine Bleeding in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654461/
Women’s Health. Polycystic Ovarian Syndrome. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
John Hopkins Medicine. Perimenopause. https://www.hopkinsmedicine.org/health/conditions-and-diseases/perimenopause
Mayo Clinic. Vaginitis. https://www.mayoclinic.org/diseases-conditions/vaginitis/symptoms-causes/syc-20354707
Mayo Clinic. Vaginal Bleeding. https://www.mayoclinic.org/symptoms/vaginal-bleeding/basics/causes/sym-20050756
Mayo Clinic. Pelvic Inflammatory Disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
Mayo Clinic. Endometriosis. https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
NIH. Uterine Leiomyomata.
The Society of Obstetricians and Gynaecologists of Canada. Abnormal Pain and Menstrual Bleeding. https://www.yourperiod.ca/abnormal-pain-and-menstrual-bleeding/heavy-menstrual-bleeding/medications-that-cause-heavy-menstrual-bleeding/
Cleveland Clinic. Vaginal Bleeding. https://my.clevelandclinic.org/health/symptoms/17899-vaginal-bleeding
by Team Thinx