Spotting between periods – causes, symptoms and prevention

Intermenstrual spotting, although often a result of natural processes in the body, such as ovulation or hormonal changes related to contraception, should not always be ignored. The most common causes of intermenstrual spotting include:

• Ovulation: Some women notice light spotting for a day or two after ovulation. This happens regularly for some people. Ovulation is the time in your cycle when you are most fertile. If you are avoiding pregnancy, make sure not to get ovulation spotting confused with menstrual bleeding!

• Contraception: Spotting between periods is a common side effect of hormonal birth control, like birth control pills, hormonal IUDS and patches, injections and implants. Spotting may occur when you start the contraceptive or shortly after stopping its use. If you experience 'break-through bleeding' every month, let your doctor know, as they can advise you on how to manage it and determine whether you should explore other contraceptive options that may be better suited to your body.

• Pregnancy: Spotting during pregnancy is a symptom that can cause concern for expectant mothers, though it does not always indicate a problem. It is estimated that up to 20% of women experience bleeding in the early stages of pregnancy, and in many cases, it is physiological – for example, during embryo implantation in the uterine wall. This type of spotting is usually light, short-lived, and not accompanied by pain. However, bleeding during pregnancy can also be a sign of more serious issues. Every case should be consulted with a doctor to ensure the safety of both the mother and the developing baby.

• Menopause: As your body prepares for this transition, you may experience hormonal imbalances that cause spotting. This can be a sign that you are starting the transition to menopause.

• Infections: Vaginal and cervical infections caused by bacteria, fungi, or viruses can lead to inflammation of the mucous membrane, causing slight bleeding between periods. Such spotting is often accompanied by other concerning symptoms, such as itching, burning, pain during intercourse, an unpleasant odour, or changes in discharge consistency.

• Uterine fibroids: Intermenstrual spotting is one of the common symptoms of uterine fibroids – benign tumours developing in the uterine muscles. Although these growths are not malignant, they can significantly affect quality of life and the regularity of the menstrual cycle. Fibroids cause irregular shedding of the uterine lining, leading to light bleeding, especially a few days before menstruation. If you experience persistent or unusual bleeding, consult your GP to rule out other underlying conditions and determine the best course of action for your health.

• Endometriosis: Intermenstrual spotting can be a sign of endometriosis – a chronic condition affecting women of reproductive age, with its exact cause still not fully understood. The disease involves the presence of endometrial tissue, which normally lines the uterus, outside its cavity – most commonly on the ovaries, fallopian tubes, or pelvic walls. This type of bleeding often occurs alongside painful menstruation, pain during intercourse, difficulties with urination or bowel movements, as well as chronic lower abdominal and lower back pain. If you experience persistent spotting, severe pain, or other concerning symptoms, consult your GP for an accurate diagnosis and appropriate management.