Sometimes, people notice small amounts of bleeding between their regular periods. This bleeding is usually (but not always) lighter than a regular period. It’s called spotting, and can look like light pink, red, or brown spots in your underwear. While spotting is common and sometimes harmless, it can sometimes be a sign of a serious health problem. That’s why it’s important to pay attention to it.
What Causes Spotting?
There are many reasons why someone might spot between periods. Here are some of the most common ones:
1. Hormone Changes
Your body uses hormones to control your menstrual cycles, and changes in those hormone levels can cause spotting. This can happen during ovulation (when your body releases an egg), in the few days right before your period starts, or as you get closer to menopause. These kinds of spotting are usually normal and not concerning. Hormonal spotting may also happen if you have thyroid problems, and may sometimes be a sign that you should adjust your thyroid treatments.
2. Birth Control
Some types of birth control can cause spotting, especially when you first start using them. These include birth control pills, patches, IUDs (small devices placed in the uterus), implants, and injections. For most types of birth control, it’s often normal to have spotting for the first 3-6 months after starting, but for some types, like IUDs and injections, spotting or irregular bleeding patterns can last 6-12 months.
3. Structural Problems
Sometimes, changes in the uterus can cause bleeding. These include:
- Fibroids: Non-cancerous growths in the uterus
- Polyps: Small lumps in the uterus or on the cervix
- Adenomyosis: When the inner lining of the uterus grows into its wall
- Endometriosis: When the tissue that’s supposed to line the inside of the uterus grows outside of it
Some of these changes are harmless, but others can cause pain, decreased fertility, or other challenges or concerns. Doctors can help treat many of these problems, so it’s important to find out what’s causing the spotting.
4. Infections
Spotting can also be caused by infections of the vagina, cervix, and uterus, including sexually transmitted infections (STIs) like chlamydia or gonorrhea. Infections can sometimes cause other symptoms too, like fever, pain, or changes in vaginal discharge. Sometimes, however, there are no other symptoms. Infections are treatable, but can cause problems if they’re not treated, so concerning symptoms should always be checked out by a healthcare provider.
5. Other Health Conditions
Some other medical problems can lead to spotting, including bleeding disorders, PCOS (polycystic ovary syndrome), liver disease, or, in some cases, cancer. Cancers can sometimes also cause symptoms like pain, bloating, pelvic pressure, weight loss, and other symptoms, but not always. Spotting can be an important warning sign. Spotting or bleeding after menopause (when it’s been more than one full year since your last menstrual period) can be a sign of a serious problem.
When Should You See a Doctor?
You should talk to your healthcare provider if you notice any of the following symptoms:
- Bleeding between periods happens for several months in a row
- Bleeding is very heavy
- You have any other new symptoms along with your irregular bleeding like fever, dizziness, or pain in your belly, lower back, or pelvis
- You bleed after menopause or during pregnancy
- The bleeding is heavy or affects your daily life
How Do Doctors Find Out What’s Going On?
Doctors may use different tools to figure out the cause of spotting. You can help them by tracking your periods and any bleeding or spotting between periods. This can help you and your healthcare provider identify any patterns, like spotting that usually happens around ovulation, or bleeding that usually happens after sex, and figure out what might be going on. Your doctor might also recommend:
- A pelvic exam
- Blood tests
- An ultrasound
- A biopsy (taking a small sample of tissue)
Once the cause is found, helpful treatments may be possible. Treatments vary and can depend on what’s causing the bleeding.
Final Thoughts
If you notice spotting between periods, keep track of when it happens and how much you bleed. Your Ovia app can be really helpful for this. Talk to a healthcare provider if you notice concerning symptoms. Finding out what’s causing your bleeding can help prevent bigger problems and keep you healthy.
Reviewed by the Ovia Health Clinical Team
Sources
- “Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women.” ACOG, Apr. 2013, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/management-of-acute-abnormal-uterine-bleeding-in-nonpregnant-reproductive-aged-women.
- “Managing an Episode of Acute Uterine Bleeding.” UpToDate, Nov. 2025, www.uptodate.com/contents/managing-an-episode-of-acute-uterine-bleeding.
- “Is Spotting between Periods Normal?” UPMC HealthBeat, 2 Dec. 2025, share.upmc.com/2025/07/spotting-between-periods/.
