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Spotting between periods is not uncommon and can have many different causes 2. In most cases, spotting represents the flow of only a small amount of blood--hence the term "spotting"--which typically takes a while to pass from the uterus to the exterior of the vagina. Fresh blood has a bright red color, but spotting is often brownish in hue because it's less fresh and has oxidized. True spotting consists of blood, however, and should therefore have very little odor.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
One of the possible reasons for spotting between expected periods is pregnancy, explain Heidi Murkoff and Sharon Mazel in their book, "What To Expect When You're Expecting." When a woman conceives, it takes seven to 10 days for the fertilized egg to travel from the site of conception in the Fallopian tube to her uterus 12. Once it reaches the uterus, the egg burrows into the uterine lining, which causes a small amount of bleeding. In some women, this bleeding never reaches the outside of the vagina, but others do notice some spotting about a week before their expected period. If the subsequent expected menstrual cycle fails to arrive, it may be worth taking a pregnancy test.
- One of the possible reasons for spotting between expected periods is pregnancy, explain Heidi Murkoff and Sharon Mazel in their book, "What To Expect When You're Expecting."
- In some women, this bleeding never reaches the outside of the vagina, but others do notice some spotting about a week before their expected period.
Birth Control Pills
Causes of Spotting Before Menstrual Period
Oral birth control pills contain small amounts of synthetic hormones that mimic the action of estrogen and progesterone. Women typically take active, hormone-containing pills for 21 days, then take placebo pills for the next seven days. The falling hormone levels during placebo days trigger a menstrual period. The McKinley Health Center explains, however, that falling hormone levels can trigger periods, or spotting, at other times as well 2. If a woman fails to take her pill at the same time each day, for instance, the body can interpret the late pill as falling hormone levels, which can initiate bleeding. Once levels start to rise again, the bleeding stops, producing symptoms of spotting. Women can avoid spotting between periods by being very consistent with their pills 2.
- Oral birth control pills contain small amounts of synthetic hormones that mimic the action of estrogen and progesterone.
- Women typically take active, hormone-containing pills for 21 days, then take placebo pills for the next seven days.
Stress and Disease
MedlinePlus, maintained by the U.S. National Library of Medicine, notes that spotting between periods may also indicate physiological or psychological problems 2. If a woman is severely stressed, her brain may alter its hormone production. This can cause periods to become more or less frequent, increase or decrease in volume, and may further cause spotting between periods 2. In general, as the stress resolves, spotting and other symptoms subside. Very rarely, spotting can indicate uterine fibroids, cancer, or other disease processes. Generally, however, these cause other symptoms as well--such as altered menstrual period frequency and duration--and pain. If spotting is minor, isn't accompanied by pain and subsides within a few days, it's highly unlikely that it's the result of a significant health disorder.
- MedlinePlus, maintained by the U.S. National Library of Medicine, notes that spotting between periods may also indicate physiological or psychological problems 2.
- Generally, however, these cause other symptoms as well--such as altered menstrual period frequency and duration--and pain.
Causes of Spotting Before Menstrual Period
Reasons for Brown Spotting Before Period
About Breakthrough Bleeding
Amenorrhea & Birth Control Pills
Causes of Not Having Menstrual Period in 6 Months
What Are the Causes of Breakthrough Bleeding While on Birth Control Pills?
About Spotting After a Period
Causes of Vaginal Labia Itching
Why Period Might Come One Week Early
Dizziness During Menstrual Cycle
- “What to Expect When You’re Expecting”; Heidi Murkoff and Sharon Mazel; 2008
- MedlinePlus: Spotting Between Periods
- Villavicencio J, Allen RH. Unscheduled bleeding and contraceptive choice: increasing satisfaction and continuation rates. Open Access J Contracept. 2016;7:43-52. doi:10.2147/OAJC.S85565
- Zigler RE, Mcnicholas C. Unscheduled vaginal bleeding with progestin-only contraceptive use. Am J Obstet Gynecol. 2017;216(5):443-450. doi:10.1016/j.ajog.2016.12.008
- Harvard Health Publishing. Dysfunctional uterine bleeding. March, 2019.
- Center for Young Women's Health. Medical uses of the birth control pill. Updated July 19, 2018,
- PCOS Society (India). Consensus statement on the use of oral contraceptive pills in polycystic ovarian syndrome women in India. J Hum Reprod Sci. 2018;11(2):96-118. doi:10.4103/jhrs.JHRS_72_18
- Weisberg E, Fraser IS. Contraception and endometriosis: challenges, efficacy, and therapeutic importance. Open Access J Contracept. 2015;6:105-5. Published 2015 Jul 27. doi:10.2147/OAJC.S56400
- Kim JJ, Sefton EC. The role of progesterone signaling in the pathogenesis of uterine leiomyoma. Mol Cell Endocrinol. 2012;358(2):223-31. doi:10.1016/j.mce.2011.05.044
- Cho MK. Use of combined oral contraceptives in perimenopausal women. Chonnam Med J. 2018;54(3):153-158. doi:10.4068/cmj.2018.54.3.153
- Cleveland Clinic. Birth control: the pill. Reviewed November 4, 2016.
- Dean J, Kramer KJ, Akbary F, et al. Norethindrone is superior to combined oral contraceptive pills in short-term delay of menses and onset of breakthrough bleeding: a randomized trial. BMC Womens Health. 2019;19(1):70. doi:10.1186/s12905-019-0766-6
Kirstin Hendrickson is a writer, teacher, coach, athlete and author of the textbook "Chemistry In The World." She's been teaching and writing about health, wellness and nutrition for more than 10 years. She has a Bachelor of Science in zoology, a Bachelor of Science in psychology, a Master of Science in chemistry and a doctoral degree in bioorganic chemistry.