Is spotting normal or should you be worried

Most women are quite familiar with spotting. At first, it makes you wonder if you’ve got your period again. And then, when you realize it was just a one-off, you exhale with relief and forget about it. But should you always ignore it? Light vaginal bleeding outside of your period is known as intermenstrual bleeding (or spotting). You might notice a spot or two of blood in your underwear - which will not necessarily require a sanitary pad or tampon, maybe just a panty liner. It can be inconvenient though. [caption id=“attachment_7518931” align=“alignleft” width=“380”]  Representational image. Image by Bastian Wiedenhaupt from Pixabay[/caption] Spotting in young women is not uncommon and is often not harmful. However, it is wise to not ignore the intermenstrual bleeding as it can be a symptom of some other health problem. Other than being inconvenient or uncomfortable, intermenstrual bleeding may cause problems like anxiety and stress. It is rarely painful. If a sexually transmitted infection or STI is the cause of the spotting, it can also lead to fertility-related problems.

Causes of spotting

Some of the reasons why spotting happens are:   1. Hormonal: Hormonal changes at the beginning of puberty and during menopause can cause spotting.   2. Structural: In late reproductive years, spotting can be because of a benign growth (non-cancerous) like polyp, fibroid, or growth on the vulva, vagina or the cervix. Though rare, spotting can also be because of reproductive and genital cancers like ovarian cancer and cervical cancer. 3. Medication-related: Some steroids and blood thinners can cause spotting.   4. Functional: When the bleeding happens for no reason.   Pregnancy, birth control pills, trauma, pelvic inflammatory diseases, endometriosis, polycystic ovaries, STIs, stress, cigarette smoking, and infections are other possible causes of spotting. Spotting can also occur after sex - this can be due to a small tear or an infection.

When to seek medical help

It’s okay to ignore spotting once in a while but you should contact your doctor if you experience any of the following:  

• Spotting doesn’t stop or if it turns into heavy bleeding.
• Women on postmenopausal hormone therapy may experience spotting for a few days in a month. This usually stops on its own, within three to six months. If, however, the bleeding is more than the usual or expected amount, or if it persists for more than six months, contact your doctor.
• Spotting in girls under eight years of age who don’t show any other sign of puberty should not be ignored.
• Vaginal bleeding should stop after menopause. Any type of spotting or vaginal bleeding after menopause is a matter of concern.
• Spotting or light vaginal bleeding can be seen in newborn girls in the first few days of their life. Excessive bleeding or bleeding that persists after the first month should not be ignored.
• Spotting accompanied by fever, dizziness, unusual vaginal discharge, abdominal or pelvic pain should be reported to the doctor.

Treatment for spotting

Depending on the other symptoms, your physician may conduct a blood, hormone, pregnancy or thyroid function test. They may also recommend an ultrasound of the pelvis, sonohysterography (special ultrasound of the uterus), Pelvic MRI (to look for fibroids or cancer) or hysteroscopy (to look for fibroids and polyps). The treatment for spotting is decided based on the underlying cause. Treatment options include medication, removal of the uterus, intrauterine devices, change in birth control pills, myomectomy (surgical removal of fibroids), scraping out of the endometriosis tissue by dilation and curettage or uterine fibroid embolization (blocking of blood flow which helps shrink the fibroids). Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on   Abnormal Uterine Bleeding_._