What is Spotting or Breakthrough Bleeding?
Spotting, also called breakthrough bleeding, is light bleeding that can occur at any point in the menstrual cycle between periods. Some women will have spotting before their period is due, some will have it midcycle around ovulation, some will have it for a few days after their period ends.
Why Do I Have Spotting?
There are a number of possible explanations for spotting:
- Implantation Bleeding/Pregnancy – spotting may be an early indicator of pregnancy, if you experience spotting and there is any chance you may be pregnant, it’s best to do a pregnancy test to confirm
- Miscarriage – the beginning of a miscarriage may also look like light spotting, it’s best to see your doctor if you are pregnant and experience any bleeding
- Ectopic pregnancy – cramping, abdominal pain and spotting can be signs of ectopic pregnancy which can be a medical emergency. If you are experiencing these and are or may be pregnant, best to see your doctor or go to emergency
- Hormonal fluctuations or imbalance – this is one of the most common causes of spotting in women who are not pregnant
- Starting, stopping, changing or missing oral contraceptives or birth control pills – inconsistent use of the birth control pill will cause hormone fluctuations that can trigger spotting. Even proper use of the birth control pill can lead to spotting if the pill isn’t the right one for you.
- Low thyroid hormone levels (low T3 or T4, high TSH) – an underactive thyroid can cause various menstrual irregularities including spotting
- Stress – under stress, your body will redirect progesterone into stress hormones, this can deplete progesterone and cause spotting
- IUDs occasionally cause slight spotting – especially after they are initially inserted
- Injury to the vagina or cervix from insertion of objects – tearing of the vagina causing any kind of trauma can lead to bleeding
- Vaginal infection – especially if combined with signs of vaginal infection like irritation, itching, burning and other discharge.
- Tumors, polyps or fibroids of the vagina, cervix, uterus or fallopian tubes
- Vaginal dryness – at perimenopause and menopause, the vaginal tissue becomes drier and thinner and more easily irritated and inflamed which can cause bleeding.
- GYNE procedures – for example, after a PAP smear or D&C spotting is entirely normal
- Some women have spotting during ovulation, which is considered normal
What Should I do About Spotting?
In most of the above instances, the spotting doesn’t pose an immediate threat to your health, but you should see your medical doctor as soon as possible for some diagnostic testing to determine the cause of the spotting.
a) If there is a known explanation like an IUD, change in birth control pill or you just had a PAP smear, then there may be no need to address the issue, but have a talk with your doctor.
b) If you are pregnant or think you might be pregnant, it’s best to see your doctor immediately.
c) If there are signs of hormonal imbalance – irregular periods – either frequent (every 25 days or less) or infrequent (every 35 days or more), heavy periods, acne, hair loss, excess facial or body hair, painful periods, bad PMS, fibroids, endometriosis or PCOS, ovarian cysts then diet, stress reduction, exercise, herbs, vitamins, and minerals can all be used to correct the hormone imbalance.
d) If there are signs of an underactive thyroid – you gain weight easily, feel cold often, have excessive hair loss on your head, feel tired, sluggish, lethargic or dull witted, it’s best to have your thyroid assessed through blood work – TSH, free T3 and free T4. If these levels indicate that you are hypothyroid, your doctor can also check to see if you have Hashimoto’s disease, which is an autoimmune thyroid problem. The thyroid can be underactive because of a nutritional deficiency, because of an autoimmune condition or for unexplained reasons. Naturopathic treatment of hypothyroidism involves nourishing the thyroid with all the nutrients it needs and in the case of Hashimoto’s, removing the immune activation that is causing the thyroid attack.
e) If there is a family history of reproductive cancers like ovarian, uterine or cervical cancer, if you have had abnormal PAP smears, if you have PCOS or suspect a reproductive cancer for any other reason, it’s best to consult your physician and have a pelvic and transvaginal ultrasound done to rule out malignancy.
What is the Natural Treatment for Breakthrough Bleeding?
As always, with naturopathic medicine we address the root cause of the problem.
Hormone imbalances (polyps, fibroids, endometriosis, PCOS, cysts) can be fixed by diet, stress reduction, exercise, herbs, vitamins, and minerals. Menopause and perimenopause symptoms can be alleviated by supporting the entire endocrine system. Thyroid disease can be moderated or solved through diet, nutritional support and moderating the immune system. Abnormal PAP’s can be turned around by supporting the immune system to fight the HPV virus, anti-virals, vitamins, minerals, and herbs.