7 Causes Of Spotting Before Period Starts

 

Are you bleeding before your expected period starts? Did you see any pinkish discharge or a light brown discharge before menstruation is due? Do you feel your spotting before period could be pregnancy?

It’s normal to get worried if you’re spotting just before your period begins. In many women, spotting is not dangerous. However, any new, persistent, very heavy or painful bleeding, or bleeding if you might be pregnant, should be checked by a doctor or sexual health clinic. nhs.uk

Most women experience the common white discharge. This occurs naturally as your body cleans your vagina while also preventing infection.

Brown spotting when you wipe or on your panties simply indicates your normal discharge is mixed with “old” (deoxygenated) blood. This could happen for many reasons and, in most cases, is not a serious health concern.

Common reasons why you could spot are pregnancy (including implantation bleeding), stress, ovulation, hormonal changes, infections, or a rough vaginal sexual intercourse before your period. Less commonly, problems like fibroids, polyps or precancerous changes of the cervix or womb may cause spotting.

Nevertheless, spotting can sometimes mean a serious health problem. Vaginal infections, uterine fibroid, effects of birth control pills and rarely cancer can cause women to spot between their periods.

This guide will explain the possible causes of spotting before your next period and when you should worry.

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What causes spotting before period?

1. Implantation bleeding (Pregnancy)

Implantation is a common reason why some women bleed before period.

What is implantation?

This is the process where the zygote (the product when the sperm fertilizes the egg) burrows into the endometrium covering your womb. This can cause the endometrium to bleed slightly.

This bleeding is called implantation bleeding or spotting. Not all women notice it, but it is one possible cause of light spotting before your period. Mayo Clinic and Cleveland Clinic describe it as very light bleeding that usually happens about 10–14 days after conception. Mayo Clinic+1

When does implantation bleeding occur?

Implantation occurs after the fertilized egg is transported back to the endometrium. This usually occurs about ten days after ovulation, and often around the time your next period is due (roughly 10–14 days after conception). 

If you notice a light, shorter-than-usual bleeding around the time your period should come, it could be due to implantation, but it can also be a light or early period or hormonal spotting.

What should I do if I have this kind of bleeding?

It can be an early sign of pregnancy, especially if it happens around your expected period and you also have other early pregnancy symptoms (breast tenderness, fatigue, nausea). But there are many other causes of spotting, so you cannot rely on bleeding alone.

What is implantation bleeding color?

Implantation bleeding is usually pinkish or brown discharge before your period. The blood from implantation mixes with your discharge forming a brown or light pink discharge.

How long does implantation bleeding last?

Implantation bleeding is usually lighter than your period and may be confused as a very light period in early pregnancy. It usually does not last more than 2–3 days. Also, you may feel implantation cramping which is usually less severe than your period cramps. 

Should I get a pregnancy test to confirm if I’m pregnant?

A test done too early (right when the spotting starts) may be negative even if you are pregnant because your hCG level is still very low. Most home pregnancy tests are more accurate from the day your period is due or a few days after. If you get a negative test but your period still doesn’t come, repeat the test after a few days or a week. Mayo Clinic+1

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2. Stress

Stress may cause you to bleed before your menstruation.

How does stress cause spotting?

Cortisol, a steroid hormone produced by the adrenal gland, directly affects your period hormones. Estrogen and progesterone are directly involved with the maturation of your endometrium. This endometrium is shed during period.

During physical or psychological stress, cortisol levels increase. Higher cortisol can disturb the normal balance of progesterone and estrogen, which may result in delayed ovulation, skipped periods, or spotting.

Other situations that may affect your cortisol level are:

• Acute illnesses

• Sleep deprivation

• Anxiety

What can I do to prevent this?

Reduce your stress level as much as possible. Do you have very stressful work days? Are your studies affecting how many hours of sleep you get? Creating time for yourself, getting enough sleep, and some regular exercise will improve your health and may stabilise your cycle. If your spotting continues despite lifestyle changes, see your doctor.

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3. Delayed ovulation

Ovulation usually occurs in the middle of the menstrual cycle — around 2 weeks before the next period. However, certain conditions may delay ovulation until a later date.

Delayed ovulation can occur due to drugs, stress or long-term medical problems like diabetes or thyroid disease.

How does ovulation cause bleeding?

Ovulation is the rupture and release of an egg from the ovary (the egg is picked up by the fallopian tube, not dropped directly into the uterus). This small rupture of the most mature ovarian follicle can cause some women to have minor bleeding. If your ovulation is shifted or delayed, it’s possible you can see spotting closer to your expected period.

How can I know it’s due to ovulation bleeding?

Bleeding due to ovulation usually occurs around the time of ovulation and is light.

If you have monitored your vaginal discharge, you will notice it becomes stretchy and hardly breaks when stretched between your fingers around ovulation (egg-white mucus).

Other ovulation signs and symptoms are:

• Breast pain and swelling

• Ovulation cramps

• Increased sexual desire

• Abdominal bloating

If your spotting before period is due to delayed ovulation, it usually clears in a few days. If it happens every month or is heavy, let your doctor know so other causes can be ruled out.

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4. Vaginal infections

Do you feel a smell down there at your vagina? Do you have fever and pain in the lower part of your abdomen?

If you have a smelly vaginal discharge that is greenish, yellowish, gray or frothy, or you have itching and burning, you may have an infection.

Vaginal and cervical infections in young women can cause bleeding anytime within your menstrual cycle and before your period. Sexually transmitted infections (STIs), pelvic inflammatory disease (PID) and severe bacterial vaginosis can all cause spotting or bleeding between periods. nhs.uk+1

If you’re not sure about your vaginal discharge odor or colour, you should inform your doctor or visit a sexual health clinic for tests.

Some of the common vaginal infections in women are:

• Candida infections / Candidiasis

• Gonorrhea

• Chlamydia

• Trichomoniasis

• Bacterial vaginosis (BV)

Any infection with pelvic pain, fever or bleeding after sex should be seen urgently.

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5. You have fibroid

A fibroid is an abnormal benign (non-cancerous) growth in the uterus. Fibroids almost never turn into cancer, but they can cause heavy periods or irregular spotting in women. Mayo Clinic+2nhs.uk+2

Fibroids are common in women of reproductive age and often shrink after menopause.

The submucous type, which is just beneath the endometrium, can cause irregular spotting before your period.

What are the symptoms of fibroid?

• Distended or enlarged abdomen

• Menorrhagia or unusually heavy period

• Difficulty getting pregnant

• Fatigue (often from anemia due to heavy bleeding)

• Difficulty in passing stool or urine if the fibroid is large

If you have symptoms suggestive of fibroids, you should inform your doctor. An ultrasound scan usually confirms the diagnosis.

Read more: Symptoms of fibroids and treatment options

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6. You started a pill or changed to a new one

Birth control pills are used to prevent pregnancy. If you’ve just started a pill, changed brand, or missed some pills, it can cause spotting.

Did you miss your pill or not take it regularly? If you missed your pill and you are spotting, you should inform your doctor or use additional contraception (like condoms) until you are sure you are protected.

However, it is not unusual to spot on the pill. In the first few months after starting your pills, you may experience light spotting (“breakthrough bleeding”). This usually improves as your body adapts to your pills. If it continues beyond 3–6 months, becomes very heavy, or you have pain, you should see your doctor.

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7. Miscarriage

Miscarriage can sometimes be the reason why you’re bleeding between periods or around the time you expect your next period.

Many very early pregnancies end before a woman even knows she is pregnant. Overall, about 10–20% of known pregnancies end in early pregnancy loss. ACOG+1

What is a miscarriage?

Most doctors use the term miscarriage or early pregnancy loss when a pregnancy ends on its own before about 20 weeks, with most happening in the first 13 weeks.

A threatened miscarriage is vaginal bleeding with or without abdominal pain where ultrasound still shows a live baby.

What should I do if bleeding is due to threatened miscarriage?

If you have a positive pregnancy test and notice brown spotting or bleeding in early pregnancy, inform your doctor or go to the hospital, especially if you have pain, heavy bleeding or feel dizzy. You may need an ultrasound and blood tests to check the pregnancy and rule out ectopic pregnancy. Bed rest alone has not been proven to stop a miscarriage, but your doctor may advise you to avoid strenuous exercise and sex until you are reviewed. ACOG

Pain relief should be taken only on your doctor’s advice in pregnancy (for example, paracetamol is usually preferred; avoid taking strong pain medicines or NSAIDs on your own).

Other forms of miscarriage are missed miscarriage (the baby has stopped growing but there is little or no bleeding) and incomplete miscarriage (some tissue remains inside the womb). Your doctor will explain treatment options such as expectant management, medicines or a small procedure. AAFP+1

How to know you’re having a miscarriage?

• You may notice brown or bright red bleeding that becomes heavier instead of stopping and may include clots or tissue.

• You feel early signs of pregnancy (breast pain, breast swelling, nausea, implantation-type cramping, fatigue) which then suddenly reduce or disappear while bleeding increases.

• Miscarriage bleeding can be light or heavy depending on the cause and may be associated with worsening lower abdominal pain.

Remember: bleeding in early pregnancy does not always mean miscarriage; sometimes it is from the cervix or implantation. Only tests and ultrasound can tell. ACOG+1

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8. Bleeding disorders in women

Bleeding disorders can affect how your body heals from an injury. This is due to low platelets or problems with clotting factors needed for wound healing.

Von Willebrand disease and hemophilia are examples. If you have difficulty with clotting, it can cause prolonged periods or spotting in between your period.

Symptoms of bleeding disorders you may experience are:

• Easy skin bruising

• Bleeding from small cuts for a long time

• Severe bleeding after a procedure or surgery

• Bleeding after tooth removal in the past

If you’ve had any of the above symptoms, then you could have a bleeding disorder. You should inform your doctor for further evaluation and blood tests.

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9. Cancer or endometrial hyperplasia

Cancer of the vulva, cervix and uterus can cause spotting in between periods. Endometrial (womb) cancer is more common in women over 40–45 years of age and usually presents with irregular bleeding (especially after menopause), bleeding between periods or bleeding after sex. NHS Inform

Endometrial hyperplasia is a thickening of the womb lining caused by long-term unopposed estrogen (for example, obesity, some hormone therapies). Both cancer and endometrial hyperplasia can cause abnormal vaginal bleeding.

Any woman who has bleeding after menopause or persistent spotting between periods should see a doctor promptly for evaluation. NHS Inform+1

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10. Intrauterine device (IUD)

IUDs are contraceptive devices that can cause spotting in women when inserted for the first time. If you just inserted a hormonal or copper IUD and you’re experiencing mild spotting, then this is often expected in the first months.

If you have very long periods, very heavy bleeding, severe cramping, foul-smelling discharge, fever, or think you might be pregnant, you should let your doctor know about your symptoms urgently to rule out infection, IUD displacement or ectopic pregnancy. Healthline+1

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10 Reasons to worry about bleeding in between periods

You should see a doctor or emergency unit if:

• Your spotting or bleeding is very heavy (soaking through pads every hour or passing large clots).

• You notice your period is lasting longer than seven days.

• Your period is very heavy with blood clots.

• You have smelly vaginal discharge that may be green, white, yellow or brown.

• You have vaginal itching with pain.

• Your abdomen is distended, and you feel a hard mass inside.

• You are losing weight after menopause with bleeding.

• You bleed easily from small injuries or cuts.

• You’re getting fatigued and weak from heavy bleeding.

• You have pain during intercourse or bleeding after sex.

• You are pregnant or could be pregnant and have any vaginal bleeding, especially with pain or dizziness. ACOG+2Mayo Clinic+2

If you have these problems, then it’s abnormal. Inform your doctor or go to the hospital as soon as possible.

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FREQUENTLY ASKED QUESTIONS

These are some common questions that may affect you. If you have more questions, let us know below.

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What causes spotting 2, 3, 4, 5 days before period?

If you notice spotting 2 or 3 days before period, it can sometimes be due to implantation and pregnancy, especially if you have had unprotected sex and later miss your period. However, short pre-period spotting is also commonly caused by hormonal changes, stress, ovulation, or birth control. Cleveland Clinic+1

Other causes are:

• Stress

• Vaginal infections

• Fibroid

• Perimenopause

• Birth control pills

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What causes spotting a week before period?

Spotting a week before period may be due to implantation in some women, but many other causes are possible (hormonal imbalance, infections, fibroids, or perimenopause).

Are you feeling nausea before period? Do you feel other signs of pregnancy like breast pain, nipple itching or abdomen pain?

If you’re spotting a week early and thinking it may be pregnancy, you should wait until about the time your period is due, and if it does not come, get a pregnancy test done. Mayo Clinic+1

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Is spotting before period pregnancy?

Yes and no. In some women, implantation of the embryo will cause bleeding, so spotting before your period can be an early sign of pregnancy. But many women who spot before period are not pregnant; their spotting is due to hormones, infections, fibroids, or other causes.

Are you more than 40 years? Then it could also be perimenopause, endometrial hyperplasia or cancer, so you should see your doctor if it persists. NHS Inform+1

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What causes brown spotting before period?

Brown spotting before period could mean you are pregnant, ovulating, or it may happen after intercourse. It can also simply be “old” blood from the end of your last period or the very beginning of a light period.

Learn more about brown mucus discharge before period.

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What causes spotting before period on birth control?

If you just started taking a pill or you are not regular with your pills, it’s possible you may have irregular spotting during the first few months. You don’t have to worry yet as it often resolves in a few months, but if it is heavy, painful or continues, see your doctor.

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What causes spotting instead of period?

If you are expecting your next period and notice a very light spotting instead of your usual period, then it might be due to implantation bleeding and you may be pregnant. A pregnancy test is the only way to know.

Other causes of spotting instead of periods are:

• Fibroid

• Vaginal infections

• Sexual intercourse

• Delayed or anovulatory ovulation

• Early or very light period

• Stress

• Emotional or academic problems

• Thyroid or other hormonal problems

• Cancer

• Uterine polyps

If you are worried your spotting may be due to pregnancy, let your doctor know or run a pregnancy test. Also see your doctor if this pattern continues for more than 2–3 cycles or you have other symptoms (pain, weight loss, fatigue).

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Now it’s your turn. Did you spot before period? Do you feel it may not be pregnancy? Let us know your symptoms if we could help.