Menstrual spotting is light bleeding that occurs outside of your menses, usually light enough that you don’t require a menstrual product like a pad or tampon.
Spotting most commonly happens right before your period and can be a sign that your period is about to start. Spotting for multiple days, mid-cycle, or recurrent spotting may be a sign of a deeper imbalance that should be evaluated further.
Here are some possible areas to explore:
Low progesterone
Progesterone is required to hold onto and maintain your lining in your luteal phase. If you have low progesterone or your progesterone starts to drop too early, this can cause spotting in your luteal phase.
Thyroid imbalance
Your thyroid can influence your menstrual cycle. Thyroid dysfunction can cause spotting and is something I’m always screening if there is an irregular cycle. Both an underactive and overactive thyroid can cause spotting, although underactive is most common. A complete thyroid panel should be considered.
Infections
Gynecological infections can also cause spotting, particularly after intercourse. Often this is accompanied by other symptoms like a change in vaginal discharge, pain, and/or fever.
The birth control pill or IUD
Hormonal contraception can also cause spotting, sometimes this can normalize, other times not. We want to evaluate whether the type of contraception is best for you, and ensure it’s not masking an underlying issue.
Anatomy
Physical causes of spotting such as fibroids, polyps, endometriosis, cervical health, etc, should be ruled out.
Lack of Ovulation
Ovulation can cause mid-cycle spotting in some individuals. A lack of ovulation can also cause irregular bleeding and spotting.
Pregnancy
Implantation bleeding - when an embryo implants into the endometrium, in some cases this causes spotting. Generally, this is very light and brief.
Nutrition
Underfueling for your body can cause changes in hormone release, which can cause menstrual disturbances including mid-cycle spotting.
Other causes
Other hormonal balances may also be assessed - high stress, prolactin, and estrogen levels could be a factor in some cases, and should be reviewed with your healthcare team.
This list may seem long, but other symptoms or blood work can usually guide us in the right direction and determine the best plan of action.
Irregular bleeding or prolonged spotting can be frustrating! It can feel like you have the longest periods or if you’re trying to conceive, feel like it’s not helping. If you have questions or want to learn more, let’s connect. Book a free discovery call to learn more.
In Health,
Dr. Ashley Damm, ND
Naturopathic Doctor - Women's Health & Fertility
Vancouver, BC