T: Reasons behind pre and postmenstrual spotting

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We all must have experienced brown discharge before and after the period ends. Spotting is different from bleeding which happens in between the menstrual cycle. Spotting happens from the upper reproductive tract or from the lower reproductive tract. One might experience heavier spotting from the upper reproductive tract (uterus) and light spotting from the lower reproductive tract (cervix). The colour of menstrual spotting is usually brown in colour or sometimes lighter which is totally different from the normal menstrual flow. Below are the major causes responsible for pre and post-menstrual spotting:

Ovulation

During the ovulation stage of the menstrual cycle, the ovaries release an egg and a tiny follicle ruptures to allow the egg to go out which leads to spots. Girls and women can figure out whether they are ovulating by analysing symptoms like increased sex drive, pain in the abdomen, breast soreness, increase in cervical mucus, etc. The spotting during this period can last for one day accompanied with mild cramps. Not all experience spotting during the ovulation phase because the phenomenon is common amongst girls and women with an excessive amount of certain hormones.

Vaginal infections

Spotting before and after the periods occurs because of vaginal infections. Pelvic inflammatory disease (PID) is one major cause behind unexpected spotting. PID usually occurs when pelvic infections are not given the required treatment. Vaginal douching is another reason responsible behind spotting in between the menstrual cycle. Sexually transmitted infections (STIs) leads to itching and swelling of the cervix which ultimately leads to spots. Certain girls observe spotting because of physical changes in the body like the occurrence of uterine fibroids, cervical polyps and endometriosis.

Hormonal contraception

Intake of hormonal contraceptives can cause spotting because of the change in hormonal levels in the body. The consumption of contraceptives leads to an increase in the progestogen which is responsible for bringing changes in the endometrium which leads to spots. Spotting also starts when women stop taking their pills or delay the intake with a few days. Combining the intake of birth control pills with other medicines can affect the effectiveness of the pills and lead to irregular bleeding. 

Pregnancy

Spotting occurs during the first semester of pregnancy because of the attachment of the fertilised egg with the uterine lining. Usually, pregnancy spotting starts even before a woman realises that she is pregnant and considers it as a period. When a woman gets pregnant, there are hormonal changes in the body as the production of progesterone starts with the formation of the placenta.

PCOS

When a girl or a woman is suffering from PCOS, the release of eggs from the ovaries is different because the eggs are surrounded by fluid-filled sacs which increases the level of male hormones (androgens) in the female body — leading to spots.

 

FAQ’s

Postmenstrual spotting may occur due to residual hormonal shifts, uterine lining changes, or irritation of the cervix. It’s usually light and short-lived. However, persistent spotting after periods, pain, or abnormal discharge should be evaluated by a doctor to rule out infections or uterine abnormalities.

Hormones like estrogen and progesterone regulate the menstrual cycle and build up the uterine lining. Imbalances can cause irregular shedding of this lining, leading to spotting before or after periods. Factors like stress, thyroid issues, or sudden weight changes can disrupt hormone levels and trigger spotting.

Yes, chronic stress affects the hypothalamus, which helps regulate hormones. When stress levels are high, hormonal balance may be disrupted, potentially causing irregular bleeding or spotting outside of regular period time. Managing stress through sleep, nutrition, and relaxation can sometimes reduce spotting.

Light spotting can be an early sign of pregnancy, known as implantation bleeding, usually occurring 6–12 days after conception. However, not all spotting is related to pregnancy. If there’s a chance of pregnancy or missed period, taking a pregnancy test and consulting a doctor is advisable.

Yes, hormonal contraceptives like pills, patches, or injections can cause spotting, especially during the first few months of use. This light bleeding is generally harmless but should be discussed with a healthcare provider if it persists or becomes heavy.

Yes, reproductive tract infections like bacterial vaginosis or sexually transmitted infections (STIs) can irritate cervical and vaginal tissues, leading to abnormal bleeding or spotting. Accompanying symptoms may include itching, unpleasant odor, or unusual discharge. Medical evaluation and treatment are important in these cases.

Consult a healthcare provider if spotting is heavy, prolonged, recurrent every cycle, or accompanied by pain, dizziness, or unusual discharge. Spotting that significantly alters your normal menstrual pattern or impacts daily life warrants professional evaluation.

Some women experience light spotting around ovulation, which occurs mid-cycle. This spotting is usually minimal and short-lived, often accompanied by mild cramping or cervical mucus changes. It’s typically normal, but persistent or heavy spotting at any time should be checked by a clinician.

Tracking your cycle with a calendar or period app helps you identify patterns, including spotting days. Record flow intensity, spotting color, symptoms, and timing. This information is valuable when discussing concerns with a doctor and can help differentiate between normal variation and potential issues.

About Author

Dr. Kanika Jain

Dr. Kanika Jain is a highly qualified and experienced medical professional specializing in Obstetrics and Gynaecology. She holds an MBBS degree from Kasturba Medical College, Manipal, and further pursued DGO from Stanley Medical College. She completed her DNB in Obstetrics and Gynaecology at Chanandevi Hospital, Delhi.