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Menstrual periods are the result of a complicated balancing act between the hormones estrogen and progesterone.

There are a variety of things that can interrupt this balance, leading to skipped periods or spotting instead of a period. Spotting is lighter bleeding than a normal flow. It generally doesn’t require much protection from a pad or tampon.

Many causes of spotting are no reason for concern and may even be normal depending on your age or other factors, such as pregnancy. Other causes might signal it’s time to see your doctor for treatment of an underlying condition.

Here are 11 possible causes for spotting instead of your period.

Spotting at the time of your period, which is around 10 to 14 days after ovulation, may be caused by implantation in early pregnancy. When implantation occurs, the fertilized egg burrows deeper into the uterine lining, causing the spotting.

Other early pregnancy symptoms:

  • swollen, tender breasts
  • nausea
  • vomiting
  • frequent urination
  • fatigue

If you suspect you may be pregnant, try taking a home pregnancy test. You may get a positive result as early as four or five days before an expected period. To avoid a false negative, it’s wise to wait until you’ve missed your period.

Chlamydia and gonorrhea are STIs that may cause spotting at any time throughout your cycle. These infections can be acquired through vaginal, oral, or anal sex. They may start with few or no symptoms or just mild signs.

As the infection progresses, spotting can happen along with other symptoms, like:

  • pain during sex
  • burning or pain during urination
  • changes in vaginal discharge
  • foul-smelling green or yellow discharge
  • nausea
  • fever
  • anal itching or discharge, soreness, or bleeding

These STIs can be treated with antibiotics. It’s important that any sexual partners get treatment as well to prevent reinfection.

PID may result when an STI goes untreated for a long period of time. It usually means that the infection has traveled from the vagina to the reproductive organs. Like other infections, it may cause irregular bleeding and spotting at the time of your expected period, and otherwise.

Other symptoms include:

  • pain in the pelvis or abdomen
  • pain with urination
  • heavy and/or foul-smelling vaginal discharge
  • bleeding after sexual intercourse
  • bleeding between periods
  • fever and chills

Treatment includes antibiotics, treatment of sexual partners, and abstinence until the infection has cleared.

Girls just starting their periods may have irregular cycles as their bodies adjust to menstruation. This typically occurs between the ages of 10 and 15. Periods during this time can be:

  • close together
  • farther apart
  • heavy
  • very light (spotting)

Over time, hormones adjust and the flow should regulate and become more predictable.

The same goes with older women. As you approach menopause, hormone levels become unpredictable. During perimenopause, periods may be heavier or lighter, longer or shorter, and more spaced out or closer together. This unpredictability may continue until periods stop altogether.

Very low body weight can impact your hormones. When the hormones are interrupted, it may stop ovulation. This may lead to a condition called amenorrhea, or one or more missed menstrual periods. Other symptoms beyond spotting include:

  • hair loss
  • headaches
  • acne
  • a milky discharge from the nipples

Excessive exercise is linked to amenorrhea as well. Too much movement can lead to what’s known as the “female athlete triad.” This refers to disordered eating, amenorrhea, and osteoporosis. Without treatment, this may lead to heart issues, weak bones, and infertility.

Ovulation is the release of a mature egg into the fallopian tube. This event typically happens around day 14 of a 28-day menstrual cycle.

Once ovulation occurs, the body produces more progesterone to prepare for possible pregnancy. If a fertilized egg doesn’t implant into the uterus, hormone levels drop and signal the body to have a period.

Whenever normal ovulation is interrupted, the menstrual cycle may become irregular. Occasional anovulation is caused by weight, age, and stress.

Long-term anovulation may be a sign of conditions, such as polycystic ovarian syndrome (PCOS). You can still have periods without ovulation. They may look like spotting or a very light flow.

Irregular periods is a symptom of PCOS. This condition is caused by hormones called androgens that can interrupt ovulation.

Instead of developing and releasing one egg each cycle, the ovaries may develop multiple follicles but not release them. When this happens, you may experience light breakthrough bleeding or spotting instead of a true period.

Other symptoms:

  • acne
  • excess body or facial hair
  • male pattern baldness
  • weight gain
  • pelvic pain
  • infertility

Treatment for PCOS includes:

  • birth control to regulate your periods
  • diet
  • exercise

An estimated women may develop a thyroid condition at some point. One of the main symptoms is irregular menstrual cycles. When too much or too little thyroid hormone is released in the body, you may spot or have only a light period. Periods can also become heavy or stop.

Other symptoms include:

  • fatigue
  • restlessness
  • weight gain or loss
  • infertility
  • issues during pregnancy

Thyroid conditions are more common directly following pregnancy or menopause.

Light periods or spotting instead of a period is also a sign of excess stress. This stress can be physical, meaning: too much exercise, strict dieting, or severe illness. It can also be emotional, which may be due to big life events, such as divorce, a death in the family, or an important work deadline.

Periods may become more painful or even stop entirely until the cause is addressed.

If you think stress is impacting your cycle, consider trying to find more ways to relax. Engaging in regular activity may help, such as:

  • yoga
  • jogging
  • walking
  • meditation
  • breathing exercises

Hormones in different birth control methods, like the pill, patch, or shot, may cause spotting instead of a normal period.

Estrogen helps to stabilize the lining in the uterus. It may shed irregularly if you’re on a method that’s low in this hormone. This symptom is more common in the months after you first start using it.

The following birth control methods can reduce periods and lead to spotting:

  • implant
  • shot
  • ring
  • patch
  • pill
  • Mirena IUD

Some methods are meant to be used continuously to help skip periods. You may also experience spotting with these methods. To get a full period, take off three to five days between packs of pills or rings.

In rare cases, you may see spotting instead of your period due to underlying cervical or uterine cancers.

Risk factors include:

  • age
  • family history of ovarian or cervical cancer
  • use of estrogen replacement therapy
  • carrying BRCA1 or BRCA2 gene mutations
  • early start to menstruation
  • late start to menopause

Early cancer may not cause any symptoms. As the cancer progresses, you may experience:

  • pain or discomfort in the pelvis
  • constipation or other bowel changes
  • weight loss
  • frequent urination
  • swelling or bloating in the abdomen
  • a feeling of fullness when eating

So, how can you tell if you’re spotting versus having your normal period? There are some key differences in the amount of blood you’ll see, the color, and other characteristics.

Spotting

Bleedingvery light
Protectionpantyliner
Colorlight red, pink, or brown
Durationcan vary
Timingany time of the month
Other symptomsdepends on the cause, but may have no other symptoms

Period

Bleedingheavy, medium, and light days
Protectiontampon, pad, or cup
Colordark red, bright red, brown, or pink
Durationgenerally 3 to 7 days
Timingmonthly flow every 24 to 38 days
Other symptomsacne

bloating

fatigue

breast tenderness

constipation/diarrhea

mood swings

insomnia

difficulty concentrating

anxiety

reduced sex drive

Seeing spotting instead of a period one month may not be a reason for concern. For example, if you’re very stressed one month or perhaps skip your period because you’re nearing menopause, your regular flow may return the following month with no treatment needed.

If your spotting is being caused by medical conditions, such as PCOS, thyroid issues, or STIs, you may experience other symptoms that prompt you to call your doctor. The same goes with possible pregnancy. Pay attention to the other symptoms you’re experiencing along with spotting and make an appointment.

Always call your doctor if your spotting is accompanied by:

  • pain
  • fever or chills
  • foul-smelling discharge
  • other signs of infection

Experiencing spotting in place of your period may be normal from time to time. There are a variety of situations that can alter the hormonal balance in the body and lead to a disrupted cycle.

Consider tracking your periods on paper or in a tracking app, like Clue. Record things like the number of days you see bleeding or spotting, the color of the blood, and the flow to watch for patterns.

If you experience other symptoms that concern you, don’t hesitate to contact your doctor.