Abnormal Menstruation – Why am I experiencing extended spotting?

An abnormal menstruation can certainly be a cause for concern among women, especially when it involves spotting for an extended period. 

What is extended spotting after a period?

Spotting is when light bleeding occurs outside of a regular menstrual period, and can indicate an underlying health issue if it continues for an extended period. Extended spotting colours can vary from pink to brown to bright red, and may be accompanied by cramping or discomfort.

What causes extended spotting?

Extended spotting can be unsettling, but understanding its potential causes and when to seek medical advice is crucial. 

Hormonal imbalances

• Hypothyroidism and hyperthyroidism disorders can disrupt menstrual cycles and cause prolonged spotting.

• Polycystic ovary syndrome (PCOS) can lead to irregular periods and spotting due to hormonal imbalances.

• Transitioning to menopause often involves hormone fluctuations that can cause spotting.

Reproductive system issues

• Uterine fibroids (non-cancerous growths) in the uterus may result in heavy periods and spotting.

• Endometriosis is when tissue similar to uterus lining grows in other places within your abdomen or pelvic area, and can cause spotting and significant pain.

• Pelvic inflammatory disease (PID) infections (of the reproductive organs) can lead to prolonged spotting.

Contraceptive methods

• Hormonal and copper intrauterine devices (IUDs) can cause spotting, especially in the first few months after insertion.

• Starting new birth control pills, missing doses, or switching pills may lead to spotting.

Pregnancy-related issues

• Implantation bleeding can cause light spotting during early pregnancy when the fertilised egg attaches to the uterine lining.

• Miscarriage or an ectopic pregnancy can lead to abnormal bleeding and require immediate medical attention.

Other medical conditions

• Cervical polyps or lesions can cause irregular bleeding and spotting.

• Blood disorders or conditions that affect clotting can lead to extended bleeding episodes.

Spotting symptoms to monitor

• Changes in bleeding patterns — Seek guidance if you begin to notice a significant change in your regular menstrual cycle or bleeding patterns.

• Accompanying pain — Take note if you start experiencing severe cramps, abdominal pain, or discomfort that comes with spotting.

• Unusual discharge — Detecting any unusual vaginal discharge that accompanies spotting, especially if it has an odour or smell.

• General symptoms — Feeling fatigued, dizzy, or other systemic symptoms that occur along with your spotting.

If you experience extended spotting, consult with a healthcare provider to find the underlying cause. By staying informed and proactive, you can better manage your reproductive health.

When to seek medical attention

You should start seeking medical attention if…

• …you start to experience intense or severe pain that is not relieved by over-the-counter medications.

• …your spotting occurs frequently between periods or continues for more than a week.

• … you observe any bleeding during pregnancy.

• …your spotting that turns into heavy bleeding that requires multiple pad or tampon changes within a short time.

FAQ

What is the difference between spotting and a period?

Spotting is light bleeding that occurs outside of your regular menstrual cycle, while a period involves heavier bleeding that lasts for several days as part of the menstrual cycle.

Can stress cause extended spotting?

Yes, significant stress can impact hormonal balance and lead to irregular bleeding or spotting.

Is spotting always a sign of a serious problem?

Not necessarily. Spotting can be caused by benign factors like hormonal fluctuations or starting birth control. However, persistent or heavy spotting should be seen to by a healthcare provider.

Can I get pregnant if I am experiencing extended spotting?

Yes, it is possible to become pregnant even when experiencing spotting, especially if the spotting is related to hormonal changes. If pregnancy is a concern, taking a pregnancy test or consulting with your healthcare provider is advisable.

How is extended spotting diagnosed?

Diagnosis may involve a combination of a physical exam, pelvic exam, ultrasound, blood tests, and sometimes hysteroscopy or biopsy to identify the underlying cause.

What treatments are available for extended spotting?

Treatment depends on the cause. Hormonal imbalances may be treated with birth control pills or hormone therapy. Infections require antibiotics, while structural issues like fibroids may need surgical solutions.

Can lifestyle changes help manage extended spotting?

Yes, maintaining a healthy weight, managing stress, and ensuring proper nutrition can help regulate menstrual cycles and reduce spotting.