Content

• To step
• Method 1 of 3: Recognize normal spotting
• Method 2 of 3: Identify abnormal spotting
• Method 3 of 3: Get medical treatment
• Tips

Vaginal blood loss between menstrual periods is also called spotting. This occurs in many girls and women and is very normal. So don't worry if you ever suffer from it. Spotting is especially common when your period is about to start, during ovulation, if you have an IUD or have started using a new form of birth control. If all of this is not the case, then intermediate blood loss should not actually occur and the spotting is abnormal. In such a case, check whether you also suffer from fever, pain, vaginal discharge (more than usual), dizziness or bruising. In addition, consider whether sex, a medical reason or a pregnancy can be the cause of the bleeding. Either way, it's important to see your doctor if you regularly experience spotting along with other symptoms.

To step

Method 1 of 3: Recognize normal spotting

1. Find out if your period should start in a few days. If you suddenly see blood on the toilet paper or in your underpants when you are not expecting it, it can be a shock. However, spotting is very common the week before your period starts. View the calendar to determine if your period is about to start. If so, the spotting is most likely normal.
   • It is useful to keep track of your menstrual cycle for yourself, for example on a calendar. You can then easily check when your next period should start and whether the spotting has anything to do with your upcoming period. Some women experience spotting every month in the days before their period. This could be the case for you too.
   • If you've never had spotting before in the days before your period started, it could be that something is wrong. This is certainly not always the case, so don't panic right away. But in this case it is wise to visit your doctor just to be sure.
2. Determine if you are in your ovulation period. Spotting occurs around ovulation in many women. Spotting in this case is caused by the mature egg released from the ovary. Usually this spotting is pink in color. This color arises because blood has mixed with vaginal discharge, which is transparent or slightly white in color. Check the calendar to see if you are on days ten to sixteen of your menstrual cycle. In that case, there is a good chance that there is ovulation.
   • Your menstrual cycle starts on the first day of your period. In most cases ovulation starts around day fourteen. This is usually a few days to a week after your period has ended.
3. Be aware of spotting if you have started using a new form of birth control. Both the pill and the IUD can cause spotting between menstrual periods. This is a fairly normal side effect of the hormones that birth control releases into your body. If you've started using a new form of birth control in the past three months, this could be the cause of the spotting.

   Variant: If you have an IUD, spotting can occur because the IUD has shifted, damaging the uterine wall. If this is the case, you may also experience pain and heavier periods in addition to blood loss. See your doctor if you think this is the case for you.

   
   
4. Find out if you have recently used any form of emergency contraception. While emergency contraception is safe to use, one of the side effects is that you may experience intermittent bleeding. This is usually nothing to worry about unless it continues to bother you. If you are concerned, it is always wise to make an appointment with your doctor to be on the safe side.
   • A well-known form of emergency contraception is the morning after pill.
   • Interim blood loss due to the morning after pill is caused by the large amount of hormones in the pill.

Method 2 of 3: Identify abnormal spotting

1. Determine if you have other symptoms. In the worst case, abnormal spotting can be the result of pelvic inflammatory disease, a medical condition or cancer. Try not to worry right away. In many cases, spotting is harmless and there are other causes. Keep a close eye on other symptoms that could indicate a medical condition. If you have any of the following symptoms, it is wise to make an appointment with your doctor for further examination:
   • You bruise easily
   • Fever
   • Dizziness
   • Abdominal or pelvic floor pain
   • More vaginal discharge than usual or it has a strange color or odor
2. Determine if the spotting is a result of PCOS. PCOS stands for "Polycystic Ovary Syndrome" and is a hormonal abnormality that often prevents ovulation. As a result, an irregular menstrual cycle develops, which can eventually lead to spotting. If you know that you have PCOS, consider whether this could be the reason for the spotting.
   • Symptoms of PCOS include: an irregular menstrual cycle, excess facial or body hair, acne, baldness or thinning hair where it is common in a man, and enlarged ovaries. Make an appointment with your doctor if you suspect you have PCOS.
3. Consider whether the spotting started after having sex. Interim blood loss can also be caused by a small damage to the inside of the vagina. Consider, for example, a scratch from a nail. In some cases, injuries that occur during sex are for medical reasons. Often there is nothing serious going on, but it is good to think about this anyway. If you've never experienced post-sex spotting before, most likely nothing is going on. If it occurs regularly after having sex, it is wise to make an appointment with your doctor to investigate further.
   • If you often suffer from vaginal dryness, sex is more likely to lead to spotting. If so, use lubricant during sex to avoid spotting in the future.
4. Take a pregnancy test if you think you may be pregnant. Spotting can occur in the first days up to the first weeks of your pregnancy. The baby then attaches itself to the lining of your uterus, which can cause minor bleeding. To find out if you are pregnant, you can take a pregnancy test at home. If it turns out that you are indeed pregnant, this could be the cause of the spotting.
   • If your pregnancy test is negative, but you also don't get your period at the expected time, take another test or see your doctor.
5. If you find out you are pregnant, see the doctor. Try not to worry right away, but there is a small chance that spotting during pregnancy is the result of a medical complication. Therefore, see your doctor to make sure that you and the baby are okay. The doctor can determine whether there is an ectopic pregnancy (the baby grows in the fallopian tubes instead of in the womb) or early signs of a miscarriage.
   • If the doctor discovers a medical complication, he or she will do everything possible to help you and the baby.
   • While this all sounds very scary, there is also a good chance that nothing serious is going on. Nevertheless, it is wise to make an appointment with your doctor immediately to be on the safe side.
6. Determine the likelihood that you have a sexually transmitted infection (STI). Some STIs cause spotting. You are more likely to have an STI if you have had unprotected sex. This also applies if the person you regularly have sex with has had unprotected sex with someone other than you. Consider getting an STI test and talking to your partner to determine if he or she is also at risk.
   • If you have an STI, there is a good chance that treatment is possible and that you will recover quickly.
7. Check the side effects of the medications you are taking. If you are on medication, this could be the cause of the spotting. Do not just stop taking your medication, but talk to your doctor first. He or she can determine whether the medications are the reason for the spotting and possibly help you find a solution.
   • Medications that can cause intermediate bleeding as a side effect include birth control pills, blood thinners, antidepressants, and antipsychotics.
   • Your doctor will probably tell you that spotting as a side effect of your medications won't hurt. If necessary, your doctor can also suggest using a different type or brand of medication.

Method 3 of 3: Get medical treatment

1. Make an appointment with your doctor if your symptoms are permanent or if you have symptoms of an infection. Try not to worry, but you may need medical treatment if your symptoms are persistent or if you experience spotting along with other symptoms that indicate possible infection. First, talk to your doctor to determine the cause of your complaints. You can then ask the doctor whether medical treatment is necessary.
   • Even if your doctor tells you not to worry, it is important to get an official diagnosis to be sure. Some forms of spotting can have a serious cause.
2. Get a diagnosis to determine what is causing the abnormal spotting. Your doctor will need to run some tests to make the correct diagnosis. These tests are painless, but may cause some discomfort. Based on these tests, your doctor can make an official diagnosis and, if necessary, discuss a treatment plan with you. Tests that your doctor can perform include:
   • A pelvic exam to detect signs of infection, uterine fibroids, abnormal growths, or cancer.
   • A Pap smear to check for infections or abnormal cells.
   • Simple, painless blood tests to check for infections or hormonal imbalances.
   • A hysteroscopy to see if you have a fibroid, abnormal growths or problems with your reproductive organ.
   • An STI test to rule out any STDs.

   Tip: If you've never had your period before, your doctor will likely only review your medical history and perform a brief physical exam. However, he or she may also want to conduct further research, for example on your blood, diabetes, thyroid, hemaglobin levels and platelets. An examination under anesthesia may also be required. If you have passed menopause, a blood test, an internal ultrasound, or a biopsy of the endometrium may be needed to rule out cancer. If you are of childbearing age, chances are your doctor will have you take a pregnancy test. In addition, a blood test, thyroid test, liver test, or hysteroscopy may be required. If you are not pregnant, the doctor will be able to perform additional tests. This includes drawing up a complete blood picture, determining your fasting glucose levels and hemaglobin levels, making an ultrasound, examining the presence of certain hormones in the blood, doing a thyroid test and possibly taking a biopsy of the endometrium. If you do turn out to be pregnant, your doctor will perform an internal ultrasound or blood test when you are in your first semester of pregnancy. In a later semester, an external abdominal ultrasound may also be performed to determine where the placenta is.

   
   
3. Call your doctor to be sure if you are pregnant. There is probably nothing to worry about, but it doesn't hurt to check in with your doctor just to be on the safe side. Sometimes spotting during a pregnancy means that something is wrong, but the doctor is the best judge of that. Make an appointment with your doctor the same day or visit a GP or emergency room if your own doctor is not available.
   • Try not to worry. There is most likely nothing to worry about. Still, it is better to err on the side of caution and have an expert check that you and the baby are all right.
4. Make an appointment with your doctor if you are past menopause and are experiencing spotting. You shouldn't have any more vaginal bleeding after menopause. If you do experience this, it may indicate that something is wrong. Make an appointment with your doctor to determine the cause and receive appropriate medical treatment if necessary.
   • Spotting after menopause can indicate, among other things, fluctuations in the hormone balance or signs of cancer. However, it can also be a final ovulation. In that case, there is no need to panic.

Tips

• It is wise to see your doctor if you have any concerns. Even if you have no symptoms of abnormal spotting. Chances are that nothing is wrong, but it is nice if an expert can reassure you about this.