skip-to-content-text

Spotting Between Periods: Causes, Symptoms and Treatments

Spotting Between Periods: Causes, Symptoms and Treatments | UPMC Italy

Is spotting between periods normal?

Spotting—defined as light or irregular bleeding between menstrual cycles—can have various causes. In most cases, it is not indicative of a serious condition, but it may signal an underlying medical issue that warrants attention.

Normal vs. Abnormal Menstrual Cycles

A regular menstrual cycle typically lasts between 21 and 35 days, with bleeding continuing for up to 7 days. Any bleeding or spotting occurring after menstruation or between cycles may be a sign of abnormal uterine bleeding (AUB). According to the American College of Obstetricians and Gynecologists, AUB may include:

  • Postmenopausal bleeding
  • Spotting or bleeding after sexual intercourse
  • Bleeding between menstrual periods
  • Excessive or prolonged menstrual flow (lasting more than 7 days or requiring more than one pad per hour)
  • Irregular cycles that are too frequent or too far apart
  • Absence of menstruation for more than 3 to 6 consecutive months

Possible Causes of Spotting Between Periods

The causes of spotting vary in severity and origin. Common causes include:

  • Hormonal imbalances (e.g., perimenopause, PCOS, use of hormonal contraceptives)
  • Endometriosis, where uterine-like tissue grows outside the uterus.
  • Uterine fibroids or polyps—benign growths that may lead to irregular bleeding.
  • Ovulation, which can occasionally trigger light spotting
  • Vaginal or sexually transmitted infections.
  • Bleeding disorders or medications that affect blood clotting (e.g., aspirin or anticoagulants).
  • Pregnancy-related complications, such as miscarriage or ectopic pregnancy.
  • Cervical conditions, including ectropion or, more rarely, cervical cancer.
  • Endometrial cancer, which is more common after menopause.

When to Consult a Gynecologist

It is always advisable to seek medical evaluation for bleeding between periods. Immediate medical attention is recommended if you experience:

  • Sudden and heavy bleeding (more than one pad per hour for over two consecutive hours).
  • Spotting accompanied by severe pain, dizziness, or difficulty breathing.

Diagnosing the Cause of Spotting

To determine the cause, your gynecologist will review your medical history and may order the following tests:

  • blood tests and coagulation studies;
  • pregnancy test;
  • Pap smear and pelvic examination;
  • pelvic or transvaginal ultrasound;
  • screening for sexually transmitted infections;
  • hormonal and thyroid function tests.

Treatment Options for Spotting Between Periods

Treatment depends on the underlying cause and may include:

Medical Therapies

  • Antibiotics for infections
  • Hormonal contraceptives to regulate the cycle
  • Medications to support clotting or reduce menstrual flow (e.g., tranexamic acid or NSAIDs)
  • Hormone therapy, particularly during perimenopause
  • GnRH agonists to shrink fibroids

Surgical Interventions

  • Endometrial ablation (removal of the uterine lining)
  • Myomectomy or hysterectomy in severe cases
  • Uterine artery embolization or hysteroscopic surgery for fibroids or polyps

Spotting between periods should not be overlooked. While often caused by benign factors, it may indicate more complex conditions that require timely diagnosis and treatment.

Learn more about gynecology services at UPMC Salvator Mundi International Hospital and book an appointment for a comprehensive and personalized evaluation.