Garden State Gynecology

Is Spotting Between Periods Normal?

Bleeding or spotting between periods can occur for many reasons.

The cause is most likely benign; for many reasons including, hormonal fluctuations that occur at the very beginning of your reproductive life cycle.

But “spotting is never normal” .  It doesn’t necessarily mean that something bad is going on, but it’s not normal.” So if you have spotting, you should call  your physician to get it checked out.

Your  healthcare provider will consider your age and whether you’re pregnant, have been having unprotected sex, or recently started using a hormonal contraceptive method.

Skipping a pill or two may also cause spotting.

Spotting in the Early Years

Spotting can mean different things at early versus later stages of your reproductive cycle.

When you first start having your period, it may be quite irregular for months or even years. This is because your brain, ovaries, and uterus are still working on getting in sync.

Once you become sexually active, spotting after intercourse may be a red flag. This is especially true if you’re having unprotected sex or have just started having sex with a new partner.

Bleeding may also be a sign of a  sexually transmitted infection (STI), such as chlamydia or gonorrhea, that should be treated promptly.

Much more rarely, post-sex spotting can even be a sign of cervical cancer. Your doctor can take a Pap smear, a sample of cells from your cervix — the opening of the uterus at the top of the vagina — to test for STIs and abnormal precancerous or cancerous cells.

Mid-cycle bleeding could also mean that you’re pregnant and could be miscarrying, although spotting during pregnancy doesn’t always mean the pregnancy will be lost. Ectopic pregnancy, in which a fertilized egg grows outside of the uterus (usually within the fallopian tubes), can also cause bleeding, according to the American Congress of Obstetricians and Gynecologists (ACOG).

Spotting may also be due to vaginal trauma. “The vagina and the cervix are very vascular [they have a lot blood vessels], so they bleed very easily.  A small scratch in the vagina will always bleed more than a scratch in in other areas.

Bleeding Between Periods in the Middle Years

Once you reach your thirties, the chance that spotting could indicate endometrial cancer, a type of cancer of the uterus, increases. Obesity also boosts your risk of endometrial cancer, even if you’re a younger woman.

Spotting “definitely becomes more worrisome after the age of 35, because it could be an early sign of endometrial cancer. Fibroids, and polyps are far more common than endometrial cancer. It’s probably one of those things, but unless you have it evaluated, you don’t know if you’re that one in 1,000 people who has the cancer.”

Fibroids are benign growths that can form in the uterus.  They are more likely to cause irregular bleeding if they grow into the uterine lining. Polyps, another type of benign growth, can also grow in the uterus or on the cervix and may cause bleeding. If required both fibroids and polyps can be surgically removed.

If your doctor suspects you may have endometrial cancer, he or she will take a sample of tissue from the endometrium so that the cells can be examined under a microscope. Other tests, such as an ultrasound, may be used to determine if bleeding is related to polyps or fibroids.

Menopause typically occurs when a woman has not menstruated for a full year — begins for most women during their fourth decade. As your ovaries begin winding down egg production, your period is likely to become irregular.

In Summary there are a multitude of reasons for spotting between periods.  They all require attention and diagnosis by your physician.