From puberty onward, we quickly become experts in our personal cycles and body changes: flow, discharge, pain, itching, discomfort during sex. But there's one symptom that can always seem worrisome, no matter what the situation: spotting between periods. Seeing the telltale red or brown staining on your pants, no matter how slight, can lead you to jump to frightening conclusions. And it's true; there are some unexpected reasons you might be bleeding mid-month.
Intermenstrual bleeding, as the professionals call it, is actually fairly common in young women, according to the Cleveland Clinic. Most often, it's known as "breakthrough bleeding" between periods, and it's quite normal. Other common causes of spotting include switching birth control methods, uterine fibroids, or the beginnings of perimenopause (the transition time before full menopause is established).
If the spotting is light, lasts only a day or two, and you have no other symptoms, there's likely no cause for worry. However, if the bleeding is prolonged or gets progressively heavier, it's time to call the doctor. Ditto and a half if you also have symptoms such as abdominal pain, fever, dizziness, or vaginal discharge, warns WebMD. And if you're postmenopausal, any bleeding at all should be brought to your doctor's attention.
Below are some of the surprising reasons you might be experiencing spotting between periods. With a couple of exceptions, these are (thankfully) fairly unusual situations. Still, any unexpected change in your cycle or body is a signal to get checked out.
1. Your Thyroid Is Off-Kilter
Your thyroid is a butterfly-shaped gland near your trachea (windpipe) that has a surprisingly large effect on your well-being. The thyroid helps control your menstrual cycle, confirmed the Office on Women's Health (a division of the federal Health & Human Services Department), and when the gland produces too much or not enough hormone, irregular periods and spotting may result. If you have spotting along with symptoms such as fatigue, weight loss or gain, dry skin, nervousness, and rapid or slow heartbeat, talk to your doctor and ask about having your thyroid levels checked.
2. You Have An Infection
Certain sexually transmitted infections, such as chlamydia, may cause bleeding between periods, explained Planned Parenthood. However, the spotting is usually accompanied by other symptoms, such as a strong-smelling discharge, pain during sex, and lower abdominal pain. Other STDs that can produce bleeding between periods include vaginitis, gonorrhea, and pelvic inflammatory disease. If you're experiencing any pelvic symptoms along with the spotting, see a doctor ASAP.
3. You've Had Rough Sex
That aggressive romp in the sheets may have been fantastic, but it may also have been tough on the tender tissues of your cervix or vaginal walls, per MedicineNet. You might also have undiagnosed vaginal or cervical polyps that are prone to bleeding from the force of intercourse. Health also noted that women with yeast infections may experience light bleeding after sex as a result of vaginal inflammation. Whatever the situation, it might be best to abstain until after you've gotten medical attention.
4. Your Ovaries Are Cystic
A condition known as polycystic ovary syndrome, or PCOS, can cause infrequent or heavy periods and spotting, according to the Mayo Clinic. PCOS is also marked by infertility and by symptoms related to an excess of the male hormone androgen in the body, such as acne and excess facial and body hair. If you notice any of these signs, particularly if you're also overweight, talk to your doctor.
5. You're Smoking Too Much
Not to nag, but your body could be telling you it's time to give the cigs a rest. Researchers have found a connection between cigarette use and early menopause (including symptoms like spotting between periods), perhaps because tobacco reduces the amount of circulating estrogen in the body. Plus, studies like this one link cigarette smoking to placenta previa and other forms of uterine bleeding during pregnancy.
7. It Could Be Cancer
Although this is probably the least likely scenario, unexpected vaginal spotting can be caused by uterine cancer, cautioned the American Cancer Society. Cervical cancer symptoms also include vaginal bleeding. Again, if you experience unexpected bleeding, particularly if you're postmenopausal, or if you also have pelvic pain or additional vaginal discharge, see your doctor.
8. You're Pregnant
Yep, you read that right. Even though a missed period is usually one of the key signs that you're expecting, one out of three women experience implantation bleeding in the very earliest days of pregnancy, according to the American Pregnancy Association. It occurs when the fertilized egg attaches itself to the uterine lining and prepares to grow into your newest family member. The spotting typically lasts a couple of days and poses no cause for concern, although you'll want to tell your doctor about it when you go in for your pregnancy checkup.