You’ve double-checked your calendar, and it’s definitely that time. But instead of a regular period, you’re spotting. What’s the deal?
First, take a deep breath. Believe it or not, spotting in place of a period isn’t uncommon. You’re one of the 5 to 35 percent of menstruating women with an irregular period this month, and there could be several reasons why.
Periods are the result of a complicated dance between hormones — progesterone and estrogen mainly, but there are others, too.
Hormones tend to vary slightly from month to month. You probably just don’t notice unless you’re the type to deeply study your flow (will the real med students please stand up?).
Here are several reasons you could be spotting instead of having a regular period, and what you can do to get it back on track.
Let’s get this one out of the way since of course you’re wondering. Early pregnancy spotting is called implantation bleeding.
It happens when a fertilized egg burrows into your uterine lining about 10 to 14 days after ovulation (read: exactly when your monthly “friend” is scheduled to make an appearance).
If you’re sexually active, watch out for these other early pregnancy signs:
- swollen, sore boobs
- unexplained nausea or vomiting
- a nonstop urge to pee
- exhaustion
What to do:
The best way to find out if you’re pregnant is to take a home pregnancy test.
But what about a false negative?
While it’s rare to have a false positive pregnancy test, false negatives do happen, especially early on. At-home tests rely on the presence of a pregnancy hormone called human chorionic gonadotrophin (HCG).
Sometimes the hormone takes a couple of weeks to show up, which means a test could be inaccurate super early in the pregnancy.
What to do:
The best way to be sure you’re not really pregnant? Buy a couple of tests, one for now and one for next week.
Hormones fluctuate at the beginning and home stretches of our most fertile years, so spotting could mean your body is adjusting to menstruation or menopause.
If you’re between 10 and 15 years old, you might still have irregular periods as your body adjusts to new hormones. That could look like:
- bleeding more than once per month
- bleeding some months, but not others
- a super heavy flow
- a spotty period
Most women stop having periods between 45 and 55 years old. Perimenopause, the years just before then, can include irregular periods with a side of hot flashes.
What to do:
If you’re younger than 15 or older than 45, your spotting could resolve within a few months. If you’re experiencing other symptoms too, your doctor can help you figure out whether the spotting is due to age or an underlying condition.
Body fat plays a crucial role in ovulation and menstruation. Your fat cells produce a hormone called leptin, and that hormone can affect your monthly cycle.
Too much body fat? You might have a spotty period because of leptin resistance.
Too little? Your body might be leptin deficient, which leads to amenorrhea — missed or super light periods. Amenorrhea can also include these symptoms.
- thinning hair
- headaches
- hormonal acne
- vaginal dryness
- nipple discharge (it might look milky)
A low body fat percentage is common if you’re athletic. While exercise is good, too much movement can lead to eating disorders, amenorrhea, osteoporosis, and fertility issues.
What to do:
If you’re struggling to maintain a healthy weight, it’s best to see your doctor. There isn’t a magic number for weight (everyone’s body type is different!) but a physician can help you pinpoint underlying issues.
Birth control messes with your hormones, which can cause spotting in place of a regular period.
Because estrogen controls the lining in your uterus, a low-estrogen birth control method might cause the lining to shed irregularly. The result? Erratic spotting.
What to do:
You can reset your cycle and get a full period by taking 3 to 5 days away from your birth control method. It’s best to do this between monthly packs of pills or rings. But remember — taking a break from birth control means you’re not protected against pregnancy.
About 2 weeks into your cycle, an egg is released into your fallopian tube. This is called ovulation, and it triggers your body toward the next phrase — your period.
So, what happens when ovulation is interrupted? A spotty period or no period at all.
Interrupted ovulation isn’t always a big deal. Sometimes it’s a result of stress, aging, or weight fluctuations. Other times, lack of ovulation is due to a medical condition like polycystic ovary syndrome (PCOS).
What to do:
Schedule an appointment with your healthcare provider or OB/GYN if you’ve had a spotty or missed period for several months in a row.
Feeling stressed AF? It’s not just your mental health at stake. Stress also affects your hormones, and hormones control your flow.
Maybe you’re exercising too hard or putting yourself through another fad diet before the holidays. Maybe you just went through a nasty breakup. Maybe you’re dealing with hectic deadlines or a nightmare boss. Regardless of the source, stress can mess with your period.
What to do:
Unfortunately, your hormones won’t chill out until you do. So take deep breaths. Go for a jog. Whatever calms your mind and body, do that.
Spotty periods are a common symptom of PCOS, short for polycystic ovary syndrome. PCOS occurs when androgens (yep, another hormone) interferes with ovulation.
With PCOS, instead of producing and dropping an egg each month, your ovaries produce tiny cysts. One of the symptoms of PCOS is light bleeding or spotting instead of a true period. Here are other symptoms:
- breakouts
- facial hair or excessive body hair
- hair thinning or a receding hairline
- weight gain
- trouble getting pregnant
What to do:
PCOS can be treated with birth control, exercise, and diet changes. It’s best to see your doctor for a full treatment plan.
Just over 12 percent of women deal with thyroid issues at some point. And what does the thyroid do? It regulates hormones.
Irregular periods are one of the main symptoms of a thyroid condition. And though you can develop a thyroid problem at any time, you have a higher risk just after pregnancy or during menopause.
Aside from spotting in place of a period, here are some signs you should get your thyroid checked:
- you’re tired all the time
- restlessness
- your weight is changing for no reason
- you’re struggling to get pregnant
What to do:
Talk to your doctor.
You know that STI you’ve been hoping would disappear on its own? Yep, that infection can turn into PID. Just like any other infection, STIs should be treated so they don’t travel to other parts of your body (like, say, your reproductive organs).
PID can mess up your period. You might experience a missed period, spotting instead of a period, or sporadic bleeding.
Here are some other signs of PID:
- pelvic pain
- pain when you pee
- nasty-smelling vaginal discharge
- bleeding after sex
- bleeding when you’re not on your period
- flu-like chills and fever
What to do:
Tell your doctor, and anyone you’ve had sex with. It’s also best to avoid sex until the infection goes away.
Speaking of STIs, when is the last time you got tested? A recent study showed that sexually transmitted infections are on the rise, which could be an answer to your low flow.
Remember, it’s possible to get an STI from any kind of sexual activity: vaginal, oral, or anal.
Both chlamydia and gonorrhea can cause irregular spotting. If you’re infected and spotting because of it, you’ll also probably have one or more of these symptoms:
- painful sex
- painful peeing
- green, yellow, or smelly vaginal discharge
- anal discharge or bleeding
- anal itching
- flu-like symptoms
What to do:
Talk to your doctor right away. Get on antibiotics before the infection worsens or spreads. And don’t forget to tell your sexual partners what’s up, so they can get treatment too if needed.
Don’t freak out, but in rare cases, spotting instead of a regular period could indicate cervical or uterine cancer.
Know your risk factors. These include:
- family history of cancer
- using estrogen replacement therapy
- having BRCA1 or BRCA2 gene mutations
- getting your period very young
- delayed menopause
- having overweight
With these cancers, symptoms often develop slowly. Be on the lookout for these issues that crop up once the cancer grows:
- pelvic pain
- changes in your poop
- unexplained weight loss
- frequent peeing
- belly bloat
What to do:
If you suspect cervical or uterine cancer, you should talk to your doctor right away.
Spotting:
| Bleeding | super light, or 1–3 on a scale of 1–10 |
| Protection | pantyliner only (sometimes a tissue, tbh) |
| Color | light red, pink, or brown |
| Duration | varies |
| Timing | any time of the month |
| Other symptoms | depends on the cause, but may have no other symptoms |
Period
| Bleeding | heavy, medium, and light days |
| Protection | tampon, pad, or cup |
| Color | dark red, bright red, brown, or pink |
| Duration | typically 3 to 7 days |
| Timing | monthly flow every 24 to 38 days |
| Other symptoms | acne bloating fatigue breast tenderness constipation/diarrhea mood swings insomnia difficulty concentrating anxiety reduced sex drive |
Remember, there are dozens of reasons your period could be messed up instead of just being messy this month. You might be stressed, sick, or nearing menopause.
Conversely, if you already have a medical condition like PCOS, thyroid problems, or an STI, you might experience other symptoms along with the spotting. In those situations, and in the event of possible pregnancy, it’s best to make an appointment with your doctor.
Always call your doctor if you experience spotting along with:
- pelvic pain
- flu-like symptoms
- smelly discharge
- other signs of infection
If you have spotting in place of your period, you’re sure you’re not pregnant, and you’ve ruled out stress or lifestyle factors, it’s best to talk to your OB-GYN.
But remember, irregular periods are usually nothing to freak out about. You’ll be better equipped to inform your doctor and notice health issues if you start tracking your periods.
Tracking apps like Clue are a great place to start. Make a note of days you’re spotting, bleeding, or experiencing discharge.
And if you start to notice concerning symptoms along with the spotting? Never hesitate to contact your doctor.
