Alarmed about light bleeding (spotting) during your menstrual cycle?
Spotting throughout your menstrual cycle can mean many different things! Spotting can be all different colors and consistencies and occur at different parts of the menstrual cycle for various reasons; some are normal and some can be cause for concern. Today we’ll walk through some of the most asked about reasons for spotting and discuss their causes!
Ovulation spotting is exactly as it sounds: a slight amount of blood that is released when ovulation occurs. Remember that eggs are released from little sacs in the ovaries, called follicles. When hormone levels reach a certain threshold, the egg is then released from the ovarian follicle, and the egg itself makes its way towards the uterus through the fallopian tubes. This release can cause spotting in some women; typically this spotting will be extraordinarily light, and you may only notice a slight, light pink discharge. It will occur near your predicted ovulation, which is typically 14 days before the start of your next period. Using ovulation tests and watching your LH peak can help you identify when your ovulation will occur and helps explain any spotting that occurs around that time. In addition, you may notice a brief twinge of pain on either the right or left side of your lower abdomen.
Implantation spotting occurs as a fertilized egg nuzzles itself into the thick endometrial lining in your uterus. The endometrium is the innermost layer of your uterus and is highly vascular (has a lot of blood vessels)! The hormone progesterone is secreted in the luteal phase to help support the proliferation of the endometrium, ensuring it is has plenty of blood vessels to nourish a newly implanted embryo. Implantation spotting typically occurs 6-10 days past ovulation and will only last for 24-48 hours. It’s typically light in color, brown or pinkish, and in minimal quantities. Clots should not appear with implantation spotting.
Period bleeding typically begins heavy and lightens as the menses progresses. Period bleeding technically indicates the end of your last cycle and is counted as “day 1” of your next menstrual cycle. The blood is typically in larger quantities for 2-4 days, lightening after that and is typically a deep or bright red or brownish in color. Clotting can be normal, but if you are passing multiple clots -- larger than the size of a quarter, it’s a good idea to discuss this heavy bleeding with your doctor. Period bleeding is often associated with mild to moderate cramping that is intermittent and lasts for a few days.
Bleeding associated with a miscarriage can be different for many women and is dependent on the duration of pregnancy (i.e. blighted ovum/chemical pregnancy vs 6 weeks vs 10 weeks gestation or development). Some women will begin to pass blood and material vaginally on their own post miscarriage, but others will not pass anything naturally and will either need medications to stimulate the sloughing of tissue or a procedure called D&C (dilation and curettage). If you have concerns of miscarriage, it’s important to seek out consult from your doctor as soon as possible.