It’s a moment that makes your heart sink. You go to the bathroom, weeks away from when your period is due, and notice pink or brownish discharge on the tissue. Immediate questions race through your mind: Is this normal? Is something wrong? Am I pregnant? First, take a deep breath. Spotting between periods – medically referred to as intermenstrual bleeding – is incredibly common. While it can be a sign of an underlying issue that needs addressing, it is rarely an emergency. However, ignoring it isn’t the answer either.
In the daily hustle and bustle, it is easy to push “minor” health niggles to the bottom of the to-do list. Your menstrual cycle, however, is a vital sign which often acts as a window to your overall reproductive health. Our guide breaks down exactly why spotting happens, what the science says, and when you should stop Googling and start booking an appointment with a specialist.
What actually is spotting?
Before we dive into the causes, it is helpful to distinguish between “spotting” and a period. A period is the shedding of the uterine lining, usually occurring every 21 to 35 days and lasting a few days to a week. Spotting, on the other hand, is much lighter. It might be:
- Light brown: Often indicating “old” blood that has taken longer to leave the uterus
- Light pink: Often mixed with cervical mucus.
- Scanty: Usually, you won’t need a tampon or a full pad; a panty liner is often enough.
If you are soaking through pads or tampons outside of your scheduled period, this is generally considered heavy menstrual bleeding (menorrhagia) rather than spotting, which warrants a different conversation with your doctor.
The Science: How common is this really?
If you feel like your cycle is unpredictable, you aren’t alone. Abnormal Uterine Bleeding (AUB) is a broad term that covers spotting, heavy bleeding, and irregular timing. It is one of the most frequent reasons women visit both GPs and private gynaecologists.
According to a significant study published in the American Journal of Obstetrics and Gynaecology examined the epidemiology of uterine fibroids – a common cause of spotting and irregular bleeding. The study highlighted that the cumulative incidence of fibroids is significant, with a major impact on women’s quality of life. The researchers noted that by age 50, nearly 70% of white women and more than 80% of black women will have developed fibroids, making it a leading cause of irregular bleeding that requires medical attention.
Common Causes of Spotting
So, if it’s not a full period, what is it? Here are the most common culprits.
- Hormonal Contraceptives
Paradoxically, the very thing many women use to regulate their cycles can often cause irregular bleeding. If you have recently started the combined pill, the mini-pill, or had a coil (IUD) fitted, “breakthrough bleeding” is very common in the first 3 to 6 months. This is essentially your body adjusting to the new hormonal baseline. Usually, this settles down, but if it persists beyond six months, you may need to switch methods.
- Ovulation (The “Mid-Cycle” Dip)
Some women experience a small amount of spotting right in the middle of their cycle (around day 14 of a 28-day cycle). This is caused by the sudden drop in oestrogen that happens right before the egg is released. It is generally harmless and often accompanied by a mild twinge of pain on one side of the lower abdomen, known as mittelschmerz.
- Stress and Lifestyle
Living in a fast-paced environment can take a toll.High levels of cortisol (the stress hormone) can interfere with the delicate balance of progesterone and oestrogen, leading to irregular spotting or missed periods.
- Sexually Transmitted Infections (STIs)
As discussed in our previous guides, STIs like Chlamydia and Gonorrhoea are often asymptomatic, but they can cause inflammation of the cervix (cervicitis). This inflammation makes the cervical tissue fragile and prone to bleeding, especially after sex. If you haven’t had a sexual health screen recently, spotting is a strong prompt to get one.
- Fibroids and Polyps
As mentioned in the study above, fibroids (non-cancerous growths in the muscle of the womb) are incredibly common. Polyps (small growths on the lining of the womb or cervix) are similar. Both can disrupt the blood flow and cause spotting between periods. While usually benign, they can grow large and cause discomfort, so monitoring them is key.
- Perimenopause
If you are in your 40s (or sometimes late 30s), your hormone levels begin to fluctuate as you approach menopause.This phase, known as perimenopause, often leads to cycles becoming shorter, longer, or more irregular, resulting in spotting.
When should you worry? The red flags
While occasional spotting is often essentially a “glitch” in your hormonal matrix, there are specific scenarios where you should definitely not ignore it. You should book an appointment with a gynaecologist if:
- You bleed after sex: Post-coital bleeding (bleeding after intercourse) should always be investigated to rule out cervical changes or infection.
- You have passed menopause: If you have not had a period for 12 months or more and suddenly experience spotting, you must see a doctor immediately. Post-menopausal bleeding is considered abnormal until proven otherwise.
- The spotting is accompanied by pain: If you have fever, pelvic pain, or foul-smelling discharge along with the spotting, it could indicate an infection like Pelvic Inflammatory Disease (PID).
- You are pregnant: Spotting in early pregnancy is very common (often called implantation bleeding), but it is always worth checking with your midwife or doctor to rule out complications like ectopic pregnancy.
What happens at the appointment?
Many women put off checking irregular bleeding because they fear the examination. However, modern gynaecology clinics in the UK are designed to be as comfortable and non-invasive as possible.When you visit a specialist, the investigation typically involves:
- A chat about your history: Your cycle length, contraception, and lifestyle.
- A pelvic exam: To check the cervix for polyps or inflammation.
- Swabs: To rule out infection.
- An ultrasound scan: This is the gold standard for spotting structural issues like fibroids or ovarian cysts.
Taking control of your cycle
It is easy to normalise irregular symptoms, especially when you are busy. You might tell yourself “it’s just stress” or “it’ll go away next month”. But your peace of mind is worth an appointment. If you are experiencing spotting between periods and want reassurance, or if you simply feel overdue for a check-up, don’t leave it to chance. For a comprehensive review of your reproductive health in a calm, discreet environment, you can book a consultation with an expert private gynaecologist in London today. Understanding why your body is bleeding when it shouldn’t, allows you to take control – whether that means changing your contraception, treating a simple infection, or managing a condition like fibroids.
