Let's be real, literally no one enjoys their period. On top of dealing with stomach cramps and mood swings, there's also the bleeding from the vagina part – which is never fun. So when you unexpectedly start bleeding (aka when you're not due on), it can be a little anxiety-inducing, and just downright annoying, right?
Unfortunately though, unexplained bleeding before your period is a thing that can happen, and it even has a name: spotting. And to make matters even more confusing, Dr Amy Novatt, a member of Dame's Clinical Board of medical advisors, explains that spotting prior to a period can be a normal part of a regular cycle.
For others though, it might not be a regular occurrence, and may even be a sign of some sort of health condition.
To help you get to the bottom of your own pre-menstrual bleeding – and alleviate any stresses you may have surrounding them – we tapped the experts for some insight. Here's everything you need to know about spotting before your period, including what it is, why it happens, and when it's worth bringing up with your doctor. After all, a 2020 study of 116 women found that 41.7% experienced one-day minimum of spotting before a period, so it's more common than you think...
Is spotting before your period normal?
It certainly can be, says intimate health, menopause, and women's wellness issues expert, Dr Shirin Lakhani. "Spotting before your period is usually completely normal. It can sometimes just be an indicator that your period is about to start and is usually due to hormonal changes during ovulation and on the lead-up to your period."
She adds that perimenopause can also play a part, as the changes it brings about in the body can "lead to irregular bleeding and spotting due to hormonal fluctuations".
If the bleeding is happening after menopause or after sex though, Dr Lakhani says this is something to pay attention to. "Spotting after intercourse may be an indicator of something more serious and should be investigated. Any bleeding after menopause should also be investigated."
What counts as spotting before a period
Dr Rebecca Brightman, a gynaecologist in New York, says that spotting or staining (doctors use the terms interchangeably) is a small amount of vaginal bleeding that happens one to three days before a period. Think: enough blood to leave a mark on light-coloured underwear, but not enough to warrant a tampon. She assures that spotting during this time frame is completely normal.
Mary Jane Minkin, M.D., a Clinical Professor of Obstetrics and Gynecology at Yale University Medical School adds that the appearance of spotting is "usually fairly light, and may be brownish, not reddish." She also notes it's not associated with cramping.
Women who take a daily birth control pill may also notice spotting if they skip a pill, or even just take it a few hours later in the day than normal. Dr Brightman says the spotting usually resolves quickly once you take the missed pill. Those with IUDs (both hormonal and non-hormonal) also tend to spot before a period.
Why you spot before a period
Your period starts when hormone levels drop, signalling a lack of pregnancy and telling your body to shed the uterine lining that would've held onto a fertilised egg. "The uterine lining typically sloughs off in a very uniform fashion, but as it starts to break down, it can bleed a little bit," says Dr Brightman.
Basically, before the uterine lining sheds and comes out (your period), the process of it starting to break down can cause slight bleeding from your uterus. This also explains why blood from spotting may look a bit lighter than your heavier, darker period blood – and it explains why this would be normal two or so days before a period (when the lining is breaking down), and not so normal five days before.
If spotting isn't a usual part of your regular cycle, there are a variety of factors that may be behind some surprise pre-menstrual bleeding. According to Dr Minkin, spotting before your period may be a sign that your body didn't produce as much progesterone as it usually does during ovulation. If this happens regularly, doctors might prescribe birth control pills or progesterone supplements, Dr Minkin adds.
"I have also heard women say they have spotting for a cycle when they are under lots of stress, travelling, [or even] spending intimate time with other women and starting to spot when another woman nearby is menstruating," says Dr Novatt.
What spotting before a period could mean
A few more serious health problems can be responsible for spotting, which is why it's so important to take note of any changes in spotting patterns (like if you start spotting and never have before, or if you start spotting five days before your period).
An overgrowth of the uterine lining
"Some women – obese women, diabetic women, and hypertensive women – are at risk of having an overgrowth of their uterine lining, and that can present as spotting," Dr Brightman says. "Certain types of overgrowth we call hyperplasia, and those put them at risk of getting uterine cancer."
A gynae-related condition
"Spotting may be a sign of other conditions such as PCOS, endometriosis, or pelvic floor disorders," notes Dr Lakhani. "You should talk these options through with your doctor and get tested if your symptoms are relevant."
These conditions are typically accompanied by other symptoms, so it's worth researching beforehand and making a note if you're experiencing any and raising that with your GP.
A polyp in the cervix
Dr Brightman adds that spotting can also be a sign of a polyp in the cervix. However, she assures you not to worry, explaining that they're "almost always benign." Of course, in rarer cases it can be a little more sinister, which is why they are removed in women who are spotting, she adds.
Cervical cancer
In even rarer instances, spotting before a period can be a symptom of cervical cancer. But Brightman also emphasises how uncommon this is, and says if cervical cancer causes any bleeding, it's typically after sex — not before a period.
You're stressed
"Stress can cause spotting between your periods as it increases your cortisol levels, which can disrupt the production of hormones such as oestrogen, progesterone and testosterone, which affect your menstrual cycle," Dr Lakhani shares. Take this as your official permission slip to kick back for an evening.
"You could try some stress-management techniques such as yoga, walking or meditation," the expert suggests.
Best period products for spotting
Can ovulation cause spotting?
Dr Lakhani confirms it can – and it's all down to those pesky changing hormones again. "You can experience 'ovulation spotting' or 'ovulation bleeding' due to hormone fluctuations," she says. "During ovulation, oestrogen levels drop which can cause some uterine lining to shred."
How and why might pregnancy be related to spotting?
In terms of pregnancy (which is kind of unrelated to this piece, but we thought we'd give it a mention anyway), spotting can be a common occurrence. According to the American College of Obstetricians and Gynecologists, 15 to 25% of pregnancies will experience spotting during the first trimester.
According to Dr Lakhani, again it all comes down to hormonal changes – and again, it may not be an immediate cause for concern (however, she does stress that if you have continuous or heavy bleeding, or if the bleeding is late in your pregnancy, it's always best to get it checked out by a doctor).
"The changes in hormone levels during pregnancy can cause you to have spotting throughout this time," the expert explains. "When a fertilised egg is attached to the lining of your uterus, it can sometimes cause what is known as ‘implantation bleeding’. This is usually at the very beginning of fertilisation, usually in the first 14 days of pregnancy."
Please never feel silly for asking your medical team to look into anything pregnancy related.
When you should see your GP
All experts agree that if you notice spotting four or more days before a period, you should talk with your GP or a gynaecologist. Ditto if it's not something that's normal for you personally.
Dr Novatt stresses that the most important thing is to track your cycle so you're aware of what's normal for you, making a note of when you experience spotting vs. regular flow, and for how long. She adds that if you start noticing pre-period spotting for more than two cycles, bring it up with your doc.
Generally speaking, though, some isolated pre-period spotting probably isn't any huge cause for concern – so please don't panic and start imagining the worse case scenario. Dr Lakhani says, "If the spotting is heavy, continuous, outside of your usual cycle, or accompanied by other symptoms such as cramping or pain, [that's when] you should consult your GP or healthcare provider."
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Kayla Kibbe (she/her) is the Associate Sex and Relationships Editor at Cosmopolitan US, where she covers all things sex, love, dating and relationships. She lives in Astoria, Queens and probably won’t stop talking about how great it is if you bring it up. Follow her on Twitter and Instagram.
Sophie Williams is a Freelance Journalist and Copywriter, covering everything from Fashion to Entertainment to music, Lifestyle and Features. She has interviewed a range of musical artists and authors including Alyssa Edwards, Courtney Barnett, Confidence Man, The Vaccines, Loyle Carner, Gabrielle, and John Niven, and has written for publications like Metro, Reader's Digest, ITV's Woo! and Vice’s NBGA. She is also working on a book for HarperCollins about Taylor Swift, due to be published in 2024.
