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This bleeding, also called "spotting," can be frustrating to deal with, especially if you aren't expecting it. Fortunately, experts note that controlling your spotting in between periods can be easily done in most cases with lifestyle changes and medication.[2]
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US Office on Women's Health
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Controlling the Spotting
Take birth control pills. Oral contraceptives, or birth control pills, are frequently used to manage spotting. Birth control pills regulate the hormonal changes that occur during your menstrual cycle. Birth control pills can help to establish a regular cycle and avoid overgrowth of the uterine lining in women that do not routinely ovulate. In women that do ovulate, birth control pills work to treat abnormal, heavy, or excessive bleeding during menstruation.
Take your birth control pills at the same time every day. Skipping a pill, or inconsistent oral contraception use, is one of the main causes of spotting. If this happens, using additional methods of contraception are strongly recommended for the duration of your cycle.
Take progestin products. Progestin is a synthetic, or manufactured form, of progesterone. Progesterone is a naturally occurring hormone released by the ovaries that helps to regulate the amount of bleeding that occurs in women that do not routinely ovulate. The synthetic form, or progestin, is most often taken in tablet form. Progestin products that are made in tablet form contain active ingredients called medroxyprogesterone and norethindrone. This type of intervention may involve taking the progestin once daily for 10 to 12 days of the month, for several months. Sometimes, progestin products are prescribed to be taken once daily every day. Other forms of taking progestin include injections, implants, or intrauterine devices.
Consider a progestin-releasing IUD. In some women that experience abnormal bleeding episodes, using an IUD, or intrauterine device that contains progestin, is a good option. This type of device is inserted into your uterus by your doctor. It has an attached string so you can check to make sure it is still in place. Progestin-releasing intrauterine devices can help to decrease the heavy bleeding by up to 50%, control episodes of spotting, plus they help to relieve some of the pain associated with monthly periods. In some cases, women that use progestin-releasing IUDs stop having their monthly cycle completely.
Change your method of birth control. If you are already taking birth control pills, talk to your doctor about changing to a different type of contraception. This may include a different formulation of birth control pills, an implantable device, intrauterine device, diaphragm, patch, or injection. If you use an intrauterine device that does not contain medication, ask your doctor about changing your IUD, or switching to a different method of birth control. IUD users have a higher rate of spotting than users of other birth control methods.
Limit your use of aspirin, ibuprofen, or naproxen throughout the month. These agents are useful in treating the pain and discomfort associated with your monthly period, but they also have the ability to thin the blood. This can make it more likely to experience episodes of breakthrough bleeding, or spotting, between your periods.
Control your stress. Excessive stress can cause your body to delay or skip your cycle altogether. Both short and long-term feelings of stress have an impact on a part of the brain called the hypothalamus. The hypothalamus is key is regulating the release of many natural chemicals throughout your body, including your ovaries, which regulate normal levels of estrogen and progesterone. When stress enters the picture, your ovaries lose their control over proper release of hormones, like progesterone. If progesterone isn't released, the build-up of estrogen can cause spotting. Both mental and physical stress can affect your menstrual cycle and create spotting. Consider moderate exercise, yoga, and relaxation techniques to help control your stress.
Maintain a healthy weight. Obesity increases your risk of uterine cancer. However, strenuous physical activity or drastic weight loss can also throw your menstrual cycle off, causing you to skip or have abnormal periods where spotting can occur.
See a gynecologist every year. An annual exam involves a pelvic exam, pap smear, and other routine tests to check for abnormalities. Let your doctor know if you have episodes of spotting. The actual pap smear and pelvic exam can sometimes cause spotting, but this is normal.
Knowing When to Seek Medical Attention
Contact your doctor immediately if you are pregnant and bleeding. The spotting or bleeding can be normal, but it may also be a warning sign of complications with the pregnancy, such as a miscarriage or an ectopic pregnancy.
Seek medical attention if you experience abnormal bleeding accompanied by other symptoms. Additional feelings of pain, fatigue, or dizziness warrant further evaluation by your doctor.
Watch for episodes of heavy bleeding. Heavy bleeding between your periods, and even during your period, can be an indicator of complications, many of which are easily managed. Contacting your gynecologist is the first step in determining the cause of the heavy bleeding and discovering possible treatment options.
See your gynecologist as soon as possible if you are postmenopausal and bleeding. Whether you are taking continuous hormone therapy, cyclic hormone therapy, or not taking hormone therapy at all, episodes of unexpected bleeding are not normal. Contact a doctor if unexpected bleeding occurs. The risk of cancer increases by about 10% in postmenopausal women that experience vaginal bleeding.
See your doctor if you stop having a period. If you go as long as 90 days without having your period, then contact your doctor.
Contact your doctor if you use tampons and develop symptoms. Stop using tampons and contact your doctor immediately if you develop a fever, muscle aches, diarrhea or vomiting, dizziness or fainting, an unexplained sunburn-like rash, sore throat, or notice redness in your eyes.
Consider other illnesses. Spotting can be caused by conditions or illnesses both unrelated and related to women’s health issues. Either way, your doctor can help to rule out other conditions or illnesses. The use of certain medications like corticosteroids, blood thinners, and even antidepressants have been linked to episodes of spotting. Thyroid disease and diabetes are also possible contributors to spotting between your periods. Women’s health conditions that may be causing the abnormal bleeding episodes can include uterine fibroids, uterine polyps, polycystic ovarian syndrome, endometriosis, bladder or vaginal infections, and cancer. Abnormal pap tests and infections like gonorrhea and chlamydia can also cause abnormal spotting. Seek medical attention as soon as possible if you continue to have abnormal bleeding or spotting.
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